Suicide
240x Art. VI.-SUICIDE. No. 2.
It would be in the highest degree discouraging to an educational reformer to be told that the success of his endeavours to persuade the masses into diligent cultivation of their intelligence might be gauged by the frequency with which suicide was committed. And yet, if we carefully analyse the nature of the influence which culture exerts on self-destruction, we are driven to the conclusion that it is an eminently evil one. Those nations which occupy the vanguard of civilisation are to be found contributing high percentages of suicides ; while the more degraded peoples, intellectually, are less suicidally inclined in proportion?all other things apart?as they are inferior in mental qualifications. We cannot avoid considering this point in connection with the equally important subject of the relation between suicide and density of population, for it is apparent on examination that there is a much more marked tendency to self-destruction among inhabitants of large towns than among a similar number of persons living scattered throughout a large tract of country. There is no difficulty in presupposing that this might be found to be so, but it is less easy to demonstrate the conditions determining the difference. One great cause, however, is that centralisation of intellectual energy in large centres of population which is attendant on civilisation at all times. In a city there are, proportionally number for number, many more busy brain workers than exist among rural populations ; there are also collected together, under conditions arising out of situation and necessity in towns, an infinitely larger number of active thinkers and workers than could find reason for exercising their capacities under the circumstances of extra-urban existence. Consequently, if these conditions are in any way such as to favour suicidal inclinations, they must of necessity find a fostering growth wherever the signs of intellectual excitement exhibit themselves. The narrowest definition of intelligence must perforce include multitudinous manifestations of it; in daily life it is not scholars only who display mental attributes of a high order ; nor is it simply in schools and colleges and private studies that worries incident to brain exhaustion, brought on by excessive head work, are experienced. The train of civilisation drags along as necessary elements of its greatness and growth, the merchant, the speculator, and the practical professional man, each of whom is as essential to human progress as the man of books, through whose devotion and encouragement imaginative studies maintain a place in the curriculum of every cultured individual. Each one of these classes, moreover, is a possible, nay more, a probable source from whence the ranks of suicides are recruited.
In order, however, to arrive at some conclusion respecting the manner in which the suicidal frenzy is developed in these different sections of society, it is necessary to consider them, to some extent, apart; and it will be profitable to deal, first, with the more strictly professional. We must avow the truth, that in the same degree as this class is increased, so does the deathrate from suicide grow also, and it is precisely in those countries where the professions are more considerably recruited that voluntary deaths show a higher figure. Indeed, the fact may be stated yet more barely and clearly, by saying that as instruction becomes more universally imparted, as scholars and schools, that is, increase, so do suicides become more numerous. That this is strictly in keeping with what has already been asserted, will be seen when it is reflected that, as the proportion of educated to the unlettered population increases, so also will the number of aspirants for higher instruction, and for professional status, be augmented; for there may be as much ambition awakened in the breast of a youth whose parents have been illiterate, while he has enjoyed the advantages of education, as in the son of a man already occupying a professional position. Moreover, the very freedom with which, in civilised countries, higher professional posts are thrown open to ambitious competitors, encourages a struggle that entails the worst evils as a nearer or remote consequence. It may not be at once that the strain of intellectual effort betrays itself, although it is no uncommon thing for overwrought school children to show signs of the injury they endure from over stimulation of their powers. Later on in life, however, the system yields to excessive pressure brought to bear on it, weakened in all such cases by undue exertions in previous years, ere yet the full strength of maturity had been gained, and the unfortunate victim of false education degenerates either to a life-long lunatic, or at once ends existence by his own act.
For this termination to many promising careers it is possible to blame nothing so much as the antiquated method of education adopted in the present day. Though it is so far true that the advancement of instruction and suicide appear to go hand in hand in all civilised countries, yet it is by no means so certain that the two need to be thus miserably associated. It must surely be conceivable that mental training of young children might be 242 suicide.
conducted on principles which, though differing widely from the method now in use, should nevertheless he equally useful with it in developing to the utmost healthy extent the capacities of the mind entrusted to its exponent’s care. The sad truth that must be faced is the stern and cruel lesson of the past, a lesson which teaches how invariably insufficient are the methods so long deemed all-sufficing, how grossly inadequate to produce the looked for result, and how by prematurely forcing the intelligences of school children, we have, in reality, been creating in many instances the nucleus of a future lunatic and possible suicide. Little as we know with certainty concerning the physical bases of madness, we are guilty of no presumption in judging that a wholly healthy brain forms no part of the insane person’s organism, or that until some sort of structural change (unrecognisable by existing aids to observation though it may be) has taken place in the brain, the phenomena of madness are not exhibited. Every such change, however, must be set up through the action of a cause, and what that cause precisely is forms the principal object of search to the practical psychologist and alienist.
Eecent events largely serve to indicate that many other forces are at work amidst the supposed influences of civilisation, to extend the area of mental affliction ; and that, considerable though it may be in determining suicidal forms of madness, education is not alone in promoting those cerebral disturbances that result in the development of insanity. Difficult as it is to discuss the necessary relations between emotional state and brain mischief, and careful as we must needs be in defining the limits and meanings of the terms employed, it is yet very essential that this aspect of the question should not be passed unnoticed. In the hvper-sensitive, and hyper-emotional sections of society, but a slight incentive is needed to develope even extravagant outbursts of excitement, the direction of which is mainly determined by the ruling influence of the time. We are familiar just now with that phase of religious excitement, reaching in many cases to actual temporary mania, which is associated with salvation revivalism, and which most large towns in the country have witnessed to some extent through the operations of the Salvation Army. Apart entirely from all questions of the religious importance of the movement, we are able to study it in the light of its effect on the numbers who are brought within the play of those forces which mainly contribute to the army’s success. Enthusiasm of an intense description undoubtedly animates at least the subordinate members of the converted class, and its numbers are so large, that many must be found in it always to respond in the fullest degree to calls upon imaginations wrought up to a great pitch of excitement by the harangues, and the accompanying bodily motion indulged in by salvation orators.
It may be deemed, perhaps, invidious to assume a connection between these performances and the very serious increase in the number of pauper lunatics in London and elsewhere. The fact, nevertheless, is incontrovertible, that within the period during which the Salvation Army has been most actively engaged in its peculiar labours, the proportion of insane persons among the classes especially appealed to and influenced by the new religious body has been visibly augmented. The lesson taught by this is but a repetition of what has previously been inculcated, and is to the effect that all purely emotional disturbances of masses of people are attended with the development of a higher proportional degree of insanity. Nor is it at all impossible to perceive that constant excitement, and the presence of a ceaseless anxiety in respect to personal well-being, must react in a serious manner upon the organisation of the individual so affected, while the nervous system will in all such cases be peculiarly liable to especial disturbances. The very intensity of a convert’s convictions will be detrimental to his mental stability; in the same way as the extent to which he is demonstrative under ‘ saving ‘ influences, will serve to indicate the limits of his intellectual strength. The less educated a person, the readier, in a general sense, will he be to adopt extravagant modes of testifying the depth of his feelings and convictions; while the more intelligent and cultured members of society, though as deeply stirred, will yet be reticent in giving outward expression to their thoughts and aspirations.
It is not being unduly, or ungenerously critical, to trace the connection between emotional excitement of an extreme degree and cerebral disturbances which demand careful treatment of those in whom they are exhibited. Keen observers, men unlikely to be misled by appearances, are convinced that such connection does exist, and do not hesitate to give public expression to their beliefs ; while also we have the unquestionable evidence afforded by the Commissioners in Lunacy that, from some cause or other, the proportion of insane persons to mentally sound is undergoing increase.
The search after principles in this connection is one of the darkest and least promising that can be engaged in ; and in order to insure any degree of successful prosecution, it is essential that every chance path that offers any prospect of leading to a truth shall be followed as far as possible. For this reason we may for a moment consider how far, and in what way, that phase of intellectual activity, which finds expres^PAKT II. VOL. VIII. NEW SERIES. S 244 suicide.
sion in the movements of so-called liberators, affects the growth of suicides. That it does influence it we cannot for a moment doubt, and in a fashion that must seriously tend, under certain circumstances, to multiply the numbers who seek by it to escape either from the difficulties which actually surround them, or those conjured up by their excited imaginations. In every country there is at this time a vast section of the population which is dominated by the teachings of socialist and nationalist leaders. In some cases the results which flow from this are no more than the legitimate rewards of very general aspirations, such as are naturally bom of improved mental and social states. In others, however, stimulated by conditions into which this is no place for inquiry, the passions aroused by propagandists find no method of satisfaction which fails to carry with it the worst consequences of social misrule, and, as we have too often witnessed, the worst type of outrage.
The effects, however, of these occurrences are not only those immediately following in the region which witnesses them; they spread far and wide wherever the ramifications of socialism have rooted; and they influence hundreds of thousands of minds which, while being capable of yielding to direction rightlyapplied, are at the same time too little versed in self-guidance to be able to reject evil tendencies when they appeal to untrained sentiment. The working population are year by year yielding an undue quota to the total of suicides, and a careful study of the details of siicli suicides afforded in accounts provided for public perusal, will enable anyone not ignorant of the history and method of socialism to draw a connection between the great movement in which the working classes claim an interest, and suicide. The leaders who initiate and direct these movements are invariably distinguished for their intellectual superiority: by reason of it they sway the opinions of the crowds who adopt their precepts; but unlike them, the latter are not armed against the reactionary powers exerted by disappointments and failures to which all great schemes, and especially those involving social revolutions, must in all times be liable. In these periods of depression, reproach, remorse, and despair find ready admission to the minds of unfortunate speculators in possibilities, and the weakest of them will not be proof against the blank misery facing them, or able to withstand the temptation to avoid its horrors.
That some such cause as this is in operation at the present time in every civilised state is assuredly true ; and equally true also is it that this is a natural and predicable consequence of that progress in civilisation which is one of our proudest boasts. We cannot improve at no cost to ourselves, and tlie most terrible price we pay is unquestionably that which is reckoned in the annual sacrifice of life by suicide.
In any study of suicide the influence exercised by the nature of professions engaged in must occupy an important position, and will offer also some very remarkable facts for consideration. Thus it would hardly be imagined a ‘priori that two such utterly dissimilar employments as those of soldier and domestic servant; would exhibit any connection in the proneness of their followers to self-destruction. And yet this is so, the strongest tendency among the latter class being seen in those dwelling in cities and considerable towns. With regard to frequency of suicide among military men, many suggestions are to be found in the statistics which have been collected on the subject, and from which it-appears that the number of suicides is greater in countries under conscript rules; and in England it has shown a steady increase since the plan was adopted of sending troops from home. Thus Dr Morselli quotes Mr. Millar to the effect, that the mortality by suicide in the English army was 0*379 per 1,000 of the forces, the rate among men between 20 and 45 years of age of the civil population for the same period having reached only 0*107, The suicidal propensity was therefore three times as strong in the army as in other branches of the population together, and this intensity even augmented as time advances. From 1862 to 1S71 it grew from 278 per million to 400, and in 1869 was as high as 569. Dr Morselli, commenting on these figures, remarks (” Suicide,” p. 260) :?” The tendency, then, increases with the sending away the troops from Europe, so that in the kingdom (at home) the number is 339 per million, but in the English possessions in India it rises to 468. We may suppose that here nostalgia, and the fatal influence of climate, play a large part. With regard to the diversity according to the arms, the unfortunate pre-eminence of the divisional corps (0*864 per 1,000 of the forces) and of the cavalry of the line (0*498) is a fact which agrees with what Lever said as long ago as 1839, lamenting the high mortality by suicide of the English dragoons, when it also was actually 785 per million. The artillery follows with 0*343 ; the infantry with 0*309 ; and the foot guards, 0*204 ; the engineers, 0*178 ; and the household cavalry, 0*164. Taking into consideration the ages of the suicides among English soldiers, we thus learn the harm of prolonged service, because the mortality by suicide, as well as that from any other cause, rapidly increases every five years from 20 to 40 years of age.”
It must not be overlooked, however, that high as the pros 2 portion of suicides is among1 military men, even with tliem it does not reach the extent to which it is found among- followers of the higher professions, amongst whom habitual and excessive brain work is a constant concomitant of existence. This relation in proportion, moreover, offers a suggestion in explanation of the causation of suicide, which will not be without value, as showing the direct, dependence of the suicidal tendency on disorganisation of the cerebral functions. In mental labours it is easy to understand how a strain is created on the nervous tissues, which in time must react injuriously in all cases where a perfect adjustment is not normally maintained. It may be insidious in action, unnoticed and unnoticeable, until attaining a limit at which normal action gives way to abnormal; but as surely as the regular processes by which the health of the brain and its surroundings is maintained are disturbed, so surely will this disturbance sooner or later result in manifestations of mental derangement. With the weak and invigorous the time is less considerable than with the robust and hearty. In the one case we can imag’ine that less resistance, due to reduced constitutional powers, will be offered to deteriorating influences than in the other, and though the result may in both cises be the same, the duration of unimpaired activity will be different. In the case of soldiers stationed away from home the causes leading to impairment of mind are less complicated, more purely physical. Organic disturbances are mainly the instruments brought into play, and through almost every vital channel the brain is attacked with more or less intensity. The busy professional man does much to help the effect of brain worry by inattention to his own physical necessities; by irregularities in eating, &c., all of which are so many modes of shaping his own destruction. Without these additional helps the foreign-placed soldier has to fight against climatic influences, the depression produced by separation from home and friends, and the numerous other discomforts of a situation so wholly unaccustomed. We might well expect that amid such unfavourable surroundings, long maintained, no inconsiderable number of minds would yield to the influences reacting1 on them with the result that suicides would become more numerous. An inexhaustible and highly interesting study is opened up to anyone who will devote time and attention to working out the comparative influences in this direction exerted by the different recognised professions, and their branches, or subprofessions. Hitherto it has not been pursued to any great extent, but material for its prosecution is both abundant and obtainable with only a reasonable amount of difficulty. Suicide among prisoners presents many points of interest to make it deserving- of being- carefully considered. That this class of the population is more prone to self-destruction than the unincarcerated there can be no question; and it is an equally incontrovertible fact that such deaths are always more numerous among prisoners in jail than amongst those in convict prisons, which, urges DivMorselli, “still more confines the close relation there is between madness, crime, and suicide, the three great corruptors of the human mind.7’ The same authority writes that ” suicide is more frequent amongst young prisoners under thirty years of age; but according to the returns of the population at large it always preponderates amongst the single and childless widowers. Peasants give 54 per cent., and the proportion of the workpeople and servants is yet higher; whilst the numbers among the liberal professions is few (in Italy 1866-74). It is noteworthy that those guilty of crimes against the person make up more than half the suicides in the prisons, and those only suspected of crime reach 38 per cent, of the total. We shall find very frequently amongst the determining motives for suicide in general, shame and remorse for crimes committed, or fears of judicial condemnation. Also in the penal establishments, the habits of an active and laborious life seem to diminish the outbreak of the tendency, since 70 per cent, of the suicides of prisoners are by those without work. Then the proportion is heavy (about 10 per cent.) among those afflicted with nervous disease, hallucinations, hypochondria, epilepsy, syphilis, affection of the tubercles, which agrees with the opinion so vigorously maintained by Despine in France, Thompson, Nicholson, and Maudsley in England, Lombron and Virgilio in Italy, that degeneration or criminal psychoses affect the constitution in all its functions, from the cerebral to the morphological.* I)r. Morselli’s meaning is quite clear as shadowed forth in this passage, although the words he employs sometimes tend to obscure it; the influence of disordered nutrition long maintained sooner or later affects the cerebral centres, and on the nature of the disturbances created therein will depend the ultimate developments of invalidism ; whether, that is, they exhibit themselves in the chronic variety of neuroses, or in the acute forms which carry in their train mania and suicidal inclinations. Perhaps it might help more fully to comprehend the nature of the problem sought to be unfolded in ? this connections if we could follow out the consequences of the treatment of individual cases, noting the direction in which remedies are of avail, and the character of each in respect to its object. To do so, however, would involve an inquiry of wearisome length, and leading to at the best but doubtful good, while it is a step gained if we can definitely satisfy ourselves that existing knowledge enables us to assume the suicidal tendency to be a necessary development of certain recognisable conditions of ill health. That it is so, undoubtedly, who can dispute ? Who would think to find an individual possessed of the mens sa?ia in corpore sctno depriving himself of existence with his own hand ? So universally is the fact of disease in connection with self-destruction recognised that an ” unsound mind” is the invariable excuse offered for the suicide in this country, and with civilised people everywhere.
The task which lies before us in the future is to discover the nature and extent of such unsoundness; to locate it, and to ascertain the conditions which give rise to and maintain it. We need not question the possibility of being enabled at some, probably not distant, date, to diagnose incipient suicidal tendency with as much precision as an approaching fever can now be predicted. In order, however, that progress may be made in this direction, it is first of all necessary to appreciate the absolute differences that separate the phenomena attending disease of the mind and disease of the body. The greatest misfortune under which psychists labour at present is their ignorance of all that relates to structural lesions of the nervous centres until these lesions are so markedly developed as to be perceptible by the coarse methods of examination open to us. For prevention to be applied with hope of successful interference, we must be able to perceive, at any rate, the existence of subtle changes in the brain structures, of which no indication has ever yet been forthcoming to observation.
And yet, notwithstanding this apparently hopeless outlook, the prospect is far from being completely poor. Such considex-able strides have been made in recent years in the science and practice of cerebral medicine, that it would be unwise to despair of even seemingly impossible conquests in the future ; and especially in the field of mental pathology, and in the lessons taught by the study of pathological anatomy, are we entitled to look for information of vast importance. Practical superintendents of asylums, who fully appreciate the nature of the resources open to them, are never weary of lamenting the absence of systematic and universal research among their order. As a rule there is too much reason to conclude that the ordinary medical officers of these establishments are extremely neglectful of the opportunities they possess for extending the limits of special knowledge of diseases incident to insanity ; and until such time as a more widespread attempt is made to utilise the materials so abundantly accessible, there is but little hope that any tangible result will be forthcoming. We must not, however, while taking note of these shortcomings be unjust to the extent of forgetting that even now some few observers are energetically pursuing investigations of a valuable and fruitful description ; and of a kind akin to those which in the past have been eminently productive. What we need particularly is that this description of inquiry shall become general, and the naturally accepted and recognised duty of every official charged with the scientific treatment of the mentally unsound. Possibly a special training may be requisite to enable a sufficient use of opportunities to be used, &c. by this class of practitioners ; but ?even under these circumstances there ought to be no interference with the proposer of an important and very necessary improvement.
An}7 attempt to formulate theories in connection with suicide must be useless, except in so far as they are supported by an appeal to facts and to statistics. The essential bearings of statistics in this direction have already been pointed out in some detail, and it would be little to the purpose to dwell further on them. There is, however, one aspect in which, as being incontrovertibly supported in fact, we may be permitted ?to place the matter, and that is, that suicide is, above all things, an indication of psychical weakness which comes into play under certain conditions in response to the action of an unerring and irresistible natural law. This has been so well expressed by Dr Morselli that we cannot do better than quote the passage in full as a conclusion to this article. ” If there was no other reasoning,” writes the learned professor, ” by which to demonstrate that suicide amongst civilised peoples is a consequence of the struggle for life, the inverse proportion which it has to crime would be sufficient to prove it.
Assassination, theft, violation are maniacal acts made use of to obtain satis.action ?f some want or instinct; they represent, in short, the morbid weapons of the competition for life. The more incapable the individual is to struggle with superior powers, the more he inclines to conquer his rival by violence. The same things happen amongst animals whose struggles are almost always stained with blood, inasmuch as they both fight in order to kill and devour the other. To conquer in such a battle the inferior organisms employ every kind of weapon, that is to say, cutting and stabbing arms, agility, poison, benumbing the currents (animal electricity), frauds, deceit, dissimulation, the alliance of the strong against the weak, and coquetry. Man makes use of these means with the greater facility the nearer he approaches to the savage state; tlie morals of the inhabitants of Terra del Fuego and Australia, who devour their women in time of famine and smoke their old people to death when they have become a burden to the tribe, are very different to ours. It may well be said that criminals instinctively revive these savage orgies among civilised peoples. They have needs, very powerful passions and desires, whose voice they blindly obey in direct ratio to the weakness of their mental organism. The criminal man, who has not wherewith to satisfy these wants, will kill and rob the other man ; he, on the other hand, in whom education instilled the sentiments of duty, will cut the thread of existence with his own hand rather than make use of these homicidal and harmful weapons. The final result is the same ; both are depraved in body and mind, and they will go forth from the combat by ditferent ways, but with identical effects; these by means of suicide, those by way of the gallows or the hangman, and this is why suicide and crime are found alternately, as already proved does come to pass among European people. It is clear that the two social phenomena have an analogous signification ; it is always the weak who give place to the stronger if it is a question of crime, and it is a weak character who is destroyed in the struggle for life when it is a question of suicide.’”
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