M'K'IUK. 



SUICIDE. 



. which forms one of the most troublesome kind* of acidity in 

 tie Btomach, and the frequent concomitant of bilious allarh, is like- 

 wise the result of such mal-avimiUtion generally of the saccharine 

 matter, though occasionally of albuminous jnattvr*. The prohibition 

 of articles of a decidedly saccharine nature from the diet of diabetic 

 patient* becomes absolutely necessary. Not only sugar in its crystalliaa- 

 ble state* must be prohibited, but those fruits which contain it A 

 single peach or pear has occasionally brought back the disease in all its 

 severity. Even those starchy or farinaceous matters which we have 

 seen to be convertible into sugar must be avoided, especially potatoes, 

 the starch of which is, of all others, the most easily transmuted into 

 sugar which is of the name nature as the diabetic sugar. 



The abuse of sugar is to be avoided by persons disposed to the 

 oxalic acid diathesis ; and persons of a bilious habit should use it with 

 great moderation, as also those with tendency to rheumatism. 

 (See ProuU 



Sugar, though prone to fermentation when in a dilute state, 

 possesses when concentrated great antiseptic properties, and is exten- 

 sively employed to preserve both animal and vegetable substances 

 from decomposition. Sometimes the sugar existing naturally in many 

 fruits is sufficient to ensure their preservation, as in figs, raisins, and 

 other dried fruits ; especially if the season has been bright and warm, 

 when more sugar is elaborated. In other cases sugar is added, as in 

 many preserves and jellies. Sugar added to meat, fish, &c., renders 

 leas salt necessary for keeping them, and preserves more of the natural 

 taste and flavour. Many medicinal substances, as well as flavours and 

 colouring principles, are preserved by means of sugar. [SYRUPS.] 

 Sugar, from the readiness with which it reduces to a metallic state 

 those bases which have a weak attraction for oxygen, has been proposed 

 as an antidote in cases of poisoning with copper, corrosive sublimate, 

 &c. It is to be doubted whether syrup is adequate to effect the reduc- 

 tion at the temperature of the stomach. On the other hand, sugar 

 yields oxygen to those substances which attract it strongly, such as 

 phosphorus; hence nothing so quickly and ivrtainly revives a fire 

 nearly extinct as throwing a little brown sugar on the embers. Sugar 

 burnt at a low temperature constitutes caramel; one part of this 

 dissolved in four parts of water constitutes the liquor (improperly 

 called linctxra) sacchari tosti, which is employed as a colouring- 

 matter for many liquids, especially for the dork-coloured sherries and 

 other wines. 



Refined sugar is much employed for the administration of volatile 

 oils, constituting foleo-saccharums. Finely powdered white sugar 

 sprinkled upon ulcers with unhealthy granulations acts as an 

 escharotic. 



The term sugar bos been applied to some substances on account of 

 then- sweet taste, which are widely different from real sugar, and 

 possess even poisonous properties, such as acetate of lead, or sugar of 

 lead. Oxalic acid, another very poisonous substance, is often called, 

 from being prepared from sugar, acid of sugar, and therefore thought 

 to be harmless. Fatal accidents frequently result from this mistake. 

 [OXALIC ACID.] 



SUICIDE is the term usually applied both to the act of self- 

 destruction and to him who commits it. As a subject of medical 

 investigation, the most important distinctions among cases of suicide 

 are founded on the circumstances which lead to its commission ; and 

 of these there are two chief classes : in one, a man is led to disregard 

 his life for the sake of something for which his death is necessary ; in 

 the other, he is depressed by an evil more intolerable than the act of 

 dying. But whichever of these be the motive, it may act in two 

 different ways, and the suicide may be, as II. Esquirol has said, either 

 acute and involuntary, or chronic and prepense. Or, again, suicides of 

 all kinds inay be divided (and this is probably the most practical 

 method) according to the condition of the mind which has preceded 

 the act, and which in each case constitutes the disposition to self- 

 destruction. 



In many cases this disposition is only a part of the general perversion 

 of the judgment in complete insanity : it thus exists in certain maniacs 

 in combination with many other signs of a diseased mind. Some are 

 merely melancholy ; some are carried on by illusions which lead them, 

 as if unintentionally, to suicide; some have sensations which they 

 imagine may be cured by such violence as proves fatal ;" some are 

 driven to the act by commands which they imagine they have received ; 

 some destroy themselves at the commencement of insanity, when they 

 are conscious of the malady which threatens them ; others, in their 

 convalescence, in horror at the excesses which they have committed, or 

 at the mere thought of having been deranged. 



There are also cases of monomania in which almost the only indica- 

 tion of insanity is the desire for self-destruction, excited by an illusion 

 respecting some melancholy event, or by some fancied command. 

 A peculiar and very terrible variety of this monomania, is that in 

 which the desire for destruction leads the patient to take the lives of 

 others, against whom he bears no ill-will, before he attempts his own. 

 Many instances of this homicidal monomania, as it is called, arc 

 recorded. 



There are conditions of the mind which are not called insanity (in 

 the ordinary acceptation of the term), but which do not less strongly 

 pmlixpose to suicide. Such is rupucially that named muni, or i 

 rite, for which, though it is thought by foreigners to be so common iu 



England that Sauvages hu called it " melancholia Anglica," we have in 

 our language no term except the very inexpressive one, ipleen. M my 

 circumstances give rise to this state of mind ; most commonly it is the 

 consequence of a want of occupation, or of a sudden transition from a 

 state of active exertion in business or in pleasure, to one of voluntary 

 or compelled repose ; or it results from the difficulty which those wlm 

 have long lived in the excitement of frivolous pursuits find iu main- 

 taining it by new objects of desire. 



The state of the hypochondriac, though of somewhat the same kind, 

 is less dangerous. He is persuaded indeed that his sufferings are irre- 

 mediable, and that death would be a great relief to him ; he even often 

 talks of committing suicide ; but he U as irresolute in the use of the 

 means of death as he is anxious in the use of those for prolonging life ; 

 and if he do at last, after repeated postponements, attempt to destroy 

 himself, the attempt is generally, through want of determination, 

 abortive, and he again sinks into the same despondency and inactivity. 



In all these cases the suicide is of the chronic or prepense kind ; and 

 in aU, the condition of mind which precedes it is connected with a 

 perversion of the judgment so obvious, that no reasonable person could 

 hesitate to regard it as insanity. Whatever ingenuity of plan may 

 have been shown in the preparation for the act, very few persons would 

 deny that, under similar external circumstances, it would not have 

 been committed by a sane man ; and this is true of the great majority 

 of prepense suicides in the present day. 



In the acute or involuntary suicides, the predisposing condition of 

 the mind is the result of circumstances which act rapidly, nnd | 

 a judgment which, before their occurrence, might be deemed smiii'l. 

 Suicides of this kind are probably less frequent than those of the pre- 

 ceding ; but they ore usually more shocking, and attract more atten- 

 tion ; they are especially common in large towns, or wherever men pursue 

 great objects at great hazards. For instance, a loss of money or of 

 honour, the failure of an ambitious enterprise, jealousy, and many 

 afflicting events, are enough at once to deprive a man of tender 

 bility of the power of just reflection, and to make him think that death 

 is not so bad as the misery which he must undergo. On the spur of 

 the moment of anguish he destroys himself. Similar circumstances 

 impel a man of colder temperament, or of a braver disposition, more 

 slowly to the same end. The one may for a time endure passively 

 his disgrace ; the other may have courage at first to bear up against 

 it ; but at length the judgment is in both alike perverted, and the 

 same state of mind is produced which urges others to immediate self- 

 destruction. 



Lastly, there are examples in which suicide is committed with perfect 

 coolness, being adopted, after due deliberation, as the most judicious 

 course which, in the circumstances of the case, and as far as the know- 

 ledge of the individual enabled him to judge, could be followed. Such 

 are many of the coses in which men, finding themselves aHlicted with 

 incurable and painful diseases, have shortened that which they believed 

 would be a miserable life ; and of the some class are the suicides com- 

 mitted iu accordance with national custom, or superstition, or from 

 patriotic motives. The cases of this class are not proper subjects for 

 medical consideration, for iu these there is no disorder of the mind. 

 The act is committed cither without deliberation, in obedience to 

 custom or authority ; or, when deliberation is used, the conclusion is 

 only the necessary result of the error in the premises. 



Such are the states of mind which most commonly predisp 

 suicide, and the circumstances which produce them. The character of 

 the act itself usually corresponds closely with that of the mind by 

 which it is urged. By those who commit it after deliberation, the 

 means employed are almost always successful ; so they are when men 

 who have endured affliction for some time, at last sink under it. But 

 when suicide is attempted under the sudden impulse of the fear of 

 disgrace, the endeavour is often abortive ; the means chosen are insuffi- 

 cient, or they are awkwardly employed ; and it deserves notice, that 

 the attempt generally seems to be the acme of the frenzy ; for if it be 

 unsuccessful, it is very rarely repeated, and often he who has mode it, 

 in the next minute seeks assistance, and bitterly repents hia folly. 



It is a generally received opinion that cold foggy climates favour the 

 development of the suicidal disposition ; but in Holland, the climate of 

 which is very similar to that of Great Britain, the proportion of miicidei 

 is lower than in any other countries with milder climates ; and that 

 many circumstances are capable of counterbalancing whatever influence 

 climate may have, is proved by the number of suicides in the same 

 country having varied considerably in different periods. It has also 

 been shown that the number of suicides, in proportion to the imputa- 

 tion, is greater in France than in England. In the year ISfiS, in 

 England and Wales the total number of suicides was 1267, of win >iu 

 921 were males, and 336 females, or 1'6 in 20,000 of the whole popula- 

 tion, or 1 in 450 of the <li 



In accordance with the same general opinion, it is commonly said 

 that suicides are more frequent in the latter port of the autumn than 

 in any other season ; but statistical inquiries would seem to indicate 

 that the kind of weather which is most favourable to the suicidal dis- 

 position is rather that of long-continued heat and drought. The 

 tendency to suicide varies greatly among persons of ditl'erent stations 

 and occupations. In a letter from Mr. Fair to the registrar-genual, 

 tliis tcndi-nry was shown to bo "least among persons v.lio carry on 

 occupation* out of doom, and greatest among artisans who are weakly 



