Popular Science Monthly/Volume 8/November 1875/Suicide in Large Cities
By ALLAN McLANE HAMILTON, M. D.
THE increased importance attached to the study of the relations of mind and body (the impetus to such study we have to thank Mr. Maudsley for) enables us to pursue our examination of certain psychical states to greater advantage than in former years. The investigation of suicide is now made much more clear as regards both the motive, behavior, and characteristics of the individual who takes his own life, and by the antecedents of his previous health, and other physical influences.
The object of this paper is to discuss the prevalence of this crime in large cities, its causes both moral and physical, and certain sanitary conditions which affect them. My observations have been made for the most part in New York, the largest city of the continent, and, as the most cosmopolitan, it offers an interesting field for research. I have made comparisons between the statistics of London and Paris, and, although it is impossible to obtain the most recent records of these two cities, I think a few hints may be gained that will be of value in preventing its increase. Statistics do not give us definite information upon the questions of heredity, cerebral injuries, neuroses, or other valuable aid in drawing conclusions, so that many important links are left out of the chain.
In all large cities the number of suicides is governed, to a great extent, by the habits, tastes, and moral culture of the people, and, back of this, by the national characteristics. For example, the French, notorious for their indifference to life, their general volatility, frequent political troubles, and exaggerated morbid sentimentality, are celebrated for the propensity to end life by their own hands.
Paris has been, and always will be, celebrated for the prevalence of this crime. The late Forbes Winslow, in his "Anatomy of Suicide," called particular attention to this national failing of the French. They pursue it as an agreeable mode of getting relief from their troubles, and, from the statesman, who blows his brains out to escape political disgrace, to the grisette of former days, who shut herself up with her little pan of charcoal, to seek oblivion from her ruin, the crime is a general one, Montesquieu, on the other hand, asserted that the English are notably a suicidal race, and that London, with its fogs and cheerlessness, is more of a city for suicides than Paris. Forbes Winslow denied this, and demonstrated that fogs had no influence whatever upon suicides; or, at least, that there were fewer suicides in foggy months than in more pleasant ones. Our own statistics substantiate this, as will be shown further on, and the months of April, May, June, July, and August, really the most pleasant of the year as regard sunshine, are those in which more people kill themselves.
The gravity and stolidity of the English people would rather show in their favor as regards this crime. In the year 1810 the number of suicides in London amounted to 188. Comparison with French statistics of the same year proved that five times as many Parisians as Londoners took this means for ending their days. French statistics show the excessive mortality from this cause. In the year 1806, 60 suicides were reported in Rouen, an extremely small city; in 1793, 1,300 in Versailles. Paris, from 1827 to 1830, furnished 6,900 suicides, an average of nearly 1.8 per year. In recent years, we have better statistical returns to work upon.
In the year 1858 the population of London was 2,720,607, and the number of suicides 283. The youngest of these was ten years, and the oldest eighty-five. In Paris, in 1853, the population was 1,053,262. There were 463 suicides, an immense number in excess of London several years later. In Turin, from 1855 to 1859, there were 108 suicides, making an average of 21 a year. In Rome, in 1871, there were only 15 suicides, showing that self-murder is very uncommon among the Italians. In the city of New York, between the years 1866 and 1872, there were 678 suicides, being an increase of 100 in the last year over the first; 511 males, 167 females. For the three years, 1870, 1871, and 1872, there were 359 suicides, 132 being Germans, a very large percentage. As regards matrimonial condition during these years, I find there were 17 married persons, 118 single, 43 widows and widowers, and 27 whose condition was not stated; 275 were males and 84 were females; the age of the oldest was eighty-six, and that of the youngest ten.
The cause for the suicide of the latter was remarkable. She was detected in a theft of fifty cents, by her mother, and, to seek escape from her shame, took Paris-green. The months in which suicide was most prevalent were those of summer. In August, 1870, there were 15 suicides, while in December only 7. In June, the following year, there were 14, and July of 1872 shows 20, and December only 4.
In regard to occupation, clerks commit suicide the most frequently, about 34 in 1870, 1871, and 1872, and but 10 laborers in the same time. The percentage of laborers abroad is greater than any other. The mode of suicide most often employed in the city of New York is that of poisoning—212 out of nearly 600 persons have died from some form of poisoning. The preference seems to be for arsenic; usually its commonest form—Paris-green. In 1872, of 50 poisoning cases, 22 took Paris-green; the others chose either opium, carbolic acid, or other irritants. In 1871, 14 took Paris-green. Nearly all of the suicides chose violent and painful poisons, there being but few exceptions. One individual ended his days by hydrate of chloral; the other, a druggist, with prussic acid. Three took chloroform. Shooting ended the lives of 147 persons; 135 hung themselves. In only one or two instances was any ingenuity shown in the suicides: one of these individuals first shot himself, and then jumped out of the window; the other threw himself in front of an advancing locomotive. In London, hanging seems to have been the method most in vogue, for, in the year 1858, 56 persons perished in this way.
A. Brierre de Boismont, in his "Recherches Médico-Légale sur Suicide," Paris, 1859, collected 4,595 cases, carbonic-acid gas and drowning being the favorite modes for self-murder with men, and strangulation with women. Of 463 suicides occurring in the year 1853, 92 men perished by carbonic-acid gas, 93 by drowning, and 131 women died by strangulation. The more ancient statistics show that voluntary starvation was a common form of suicide in the beginning of this century. The motive for suicide in the reported cases was extremely difficult to discover. Of the 463 cases in Paris in 1853, insanity produced the suicide of 53 men, 37 women; drunkenness, 48 men, 14 women; misery and grief, 20 men, 8 women; disappointed love, 28 men, 20 women; shame, 18 men, 9 women; domestic trouble, 18 men, 15 women; weariness of life, 20 men, 7 women; disease, 27 men, 19 women; fear of the law, 16 men, 2 women; ill-luck, 23 men, 14 women; trouble with parents, 5 men, 5 women; loss of situation, 8 men; loss of parents, 1 woman. By this table, it will be seen that insanity causes the largest number of suicides, both of men and women; drunkenness comes next, and disease third.
In regard to the form of suicide with fire-arms, Boismont shows, by a carefully-arranged table, that the greatest number shoot themselves in the mouth, seventy-five per cent, choosing this means.
Out of 368 cases, 234 shot themselves in the mouth, 71 in the abdomen and thorax, 26 in the temple, and but 1 in the ear, thus showing a knowledge of the vital parts of the body. In illustration of the coolness and resolution of these suicides, he found that 85 left wills. The chirography of letters and various communications written before death was steady and natural, not betraying any signs of weakness, trembling, or irresolution on the part of the writers. Parisian statistics prove that of 3,518 cases, 2,094 occurred in the daytime, 766 in the evening, and 658 at night, proving that daylight is most agreeable for this kind of work. The ages at which suicide seems to be most often resorted to are between forty and fifty among the men, and forty-five and fifty-five among the women.
The greatest number of suicides in the city of New York, as I have said, are by poison, and this mode of self-destruction being the favorite one, we are naturally led to inquire why it should be so. When we take into consideration the looseness of our present laws regarding the sale of poisonous drugs, and the comparative ease by which suicides can procure the agents for their destruction, we have very little cause for wonderment. The number of cases of accidental death which have occurred through the criminal carelessness of certain druggists, who deal the most deadly drugs to persons unknown to them, is worthy of serious comment. There appears to be no difficulty for the would-be suicide to buy just what poison he desires. A large proportion of the inhabitants of great cities are confirmed in certain pernicious habits. Among them are opium-eating and chloroform-taking, which they pursue to what extent they choose, as these articles are always to be had.
It is needless to say that the opium-habit, like alcoholism, frequently leads to self-destruction.
In this country, upon several occasions, certain individuals have taken their own lives after insuring them, that the policy might be paid to the family of the suicide. This is an example of a very interesting psychical condition. Alcohol and its secondary effects have swelled the number of suicides, and the victims who have died by their own hands have been equally of the higher and the lower classes in this country. I think a great increase in the returns of mortality of this especial variety of suicide would be observed if the reporting physicians would conscientiously state the cause of death. The shame attached to the procedure, particularly among people of position, has prompted the return to be made of "meningitis," "cerebral congestion," or other diseases. Within the last two years, I can call to my mind the suicide of six people of high social position, caused by drink. This vice is perhaps not entirely characteristic of large towns, but the facility for indulgence of the habit, and the numerous ways of drinking in private, are more perfect in the cities.
In smaller places, there is a certain amount of contact with one's fellows, which makes him the cynosure of all eyes, should he indulge too freely. As I have before said, the busy life men lead in the metropolis, and the necessity for brain-stimulus, accelerate the facilis descensus. The disgrace of men in high position, impending ruin and other facts, will often prompt suicide as a mode of relief.
A form of suicide which figures largely in American statistics is, jumping from an elevation. This may be chosen by the individual as an effectual method, if he hesitates to select one, or may be the result of a momentary state of delirium produced by the surroundings. This latter is a common form in some European cities that contain high churches, monuments, or towers. I have myself experienced a morbid desire of this character, after an ascent of the Mountain Corcovado, in the harbor of Rio de Janeiro. When looking over a steep precipice upon this bay, two thousand or more feet below, I felt a strange restlessness and distention of the blood-vessels, with an irresistible desire to leap out into the clear air. This disappeared when I looked upon some object near by. A medical friend relates a case in his own experience. He went with an acquaintance up into a very high, unfinished public building. There was no evidence of insanity in his acquaintance. When my friend's back was turned, his companion jumped far out into the air, and fell mangled to the sidewalk. In France this form of suicide is a very common one, 45 individuals in the year 1820 having precipitated themselves from heights. In the year 1852, 16 men and 19 women chose this means of self-murder. So prevalent were those suicides, that the authorities refused admission to the Column Vendôme. As I have before said, this method is not an unusual one. In New York, between the years 1866 and 1872, there were 21 victims.
Dr. C. P. Russell, of New York, has informed me of a friend who is to such an extent the subject of the impulse to throw himself from heights, that he will never sleep upon the third or fourth floor of any dwelling.
The impulse to commit suicide with sharp-cutting instruments has been more common in the European cities than those of this country, and, in the majority of instances, suicide by these weapons has been resorted to by insane subjects.
A most important study in connection with this subject is the influence of the mode of life of the poorer classes. I allude more particularly to the tenement-house system—to the colonization of many thousand people in a limited space, much too small for them. They are brought together so, that every vice becomes, to a great degree, contagious. Bad examples are followed by the younger generation, and it is much easier for a seed of sin to take root here than one of virtue. Families of several nationalities are closely packed together in front and rear houses. Ground and labor are so expensive, in the larger cities particularly, that this mode of living is unavoidable.
Despite the earnest efforts of an efficient health board in the city of New York, many radical defects exist, and ventilation, light, and drainage, are defective in the extreme. Diseases of the nervous system, principally of the trophic character, exist to a great extent, as results of imperfect lighting and ventilating.
In the five years preceding 1872 the deaths from nervous diseases in New York averaged 3,155.8, and for the years 1871 and 1872 were over 6,000, an unusually large proportion, the number of deaths from all causes being 59,623. The vices attending the colonization of the working-class (a great many do not work) are contagious, the moral contact of the vicious with the pure is certain to occur, the ruin of young girls, and depression of tone, are powerful inducers of suicide.
The American people partake of the characteristics of their transatlantic brethren. They are impulsive, energetic, enterprising, emotional, liable to excessive mental depression or exaltation. We have all the different bloods of Europe in our veins. We lead, however, an individual life of our own, a life as original and striking as other startling peculiarities of our country. We live too fast; we make and lose fortunes in a day; we acquire professional educations in a few years which take ordinary individuals as many more to get the rudiments of in Europe. It is any thing but festina lente here. The seeds of every national soil are sown, and take root before we can employ measures to suppress them. Every thing that can excite the emotions, make tense the mental faculties, and suddenly relax them, is among us. Speculations and stupendous schemes, which in older countries take several heads instead of one to mature, crush down the nervous system of men who work themselves to death, hardly taking time to eat, meanwhile living upon stimulants to enable them to stand the strain.
There is another class—I allude to the poor. The newspaper accounts of the miserable suicide in his upper attic tell this story every day. These subjects are chiefly foreigners, deluded to this country by unfounded expectations of fortunes to be made.
Only a few days ago I read in one of the daily papers that it was not an uncommon occurrence for immigrants to ask of the officials at Castle Garden, in perfect good faith, positions as insurance officers, bank officers, and other unattainable positions.
Many thousand Italians were sent here by rascally agents in their own country several years ago. They were promised work by these individuals, but on their arrival found none. They reached New York in mid-winter, and many of them found their way into the workshops and almshouses. Misery and suffering were prevalent. Among immigrants, particularly the Germans, there is a great disposition to suicide, and physical suffering doubtless awakens any hereditary tendency that may lie dormant. A great percentage remain at the seaport, looking for work. New York is particularly affected in this way. Immigrants come here, probably in most instances from occupations much more steady and remunerative in comparison to any found here; trades-people, skilled workmen, and mechanics, often commit suicide, who find it difficult to obtain employment, and finally hunger and disappointment drive them to this step.
The prevalence of strikes, and trades-unions, with their dangerous restrictions and foolish oaths of allegiance, are fruitful causes of suicide. Men are afraid to work in opposition to the threats of their fellow trades-unionists, and, as poverty stares them in the face and they become desperate, they commit suicide.
A necessary attendant upon increase in population is immorality, engendered by vice attendant upon civilization. The more depraved forms of theatrical amusement found at the low theatre halls, two or three of which now exist in New York, wipe out all of the original purity from the nature of the weak-minded spectators. The low songs at some of these places, abounding in double entendres and suggestive gestures, inflame the dormant instincts of lust in the minds of the deeply-interested audience.
Prostitution is a very easy way leading to suicide. The attendant vices of this class very soon destroy the mind. Opium-eating, inebriety, and snuff-chewing, are habits which nearly all prostitutes follow after a time. The classification of these causes of suicide and their victims is very incomplete, and prostitution is placed on the records in only one instance in 1871, 1872, and 1873, as the calling of the individual.
The prevalence of seduction in large cities is perhaps greater among the lower classes—the workers in factories and shops. Indeed, the chance for this crime among the many thousand young girls and men who are herded together indiscriminately in the large tobacco, hoop-skirt, paper-box, and other factories of great cities, is often made use of. Suicide follows ruin, though not in as many cases as it would in France. I do not doubt but that the large rivers, upon which most American cities are built, give up a great many bodies of unfortunates who end their moral ruin by suicide. In fact, the number of cases reported as "found drowned" may be assumed in general to be suicidal.
In our own cities, as I have before shown, clerks seem to be the class that most often take their own lives. This seems reasonable when we consider the peculiar careers of a great many of them—the temptations of vice, the struggles for situation and support, and the pitfalls of a large city.
How shall we prevent the increase of this crime which advances at the rate of 300 per cent, in seven years? What sanitary measures can be taken to defeat its moral and physical causes?
It is a stupendous undertaking. To reduce its statistics would require an attack upon our whole social system.
I have pointed out the rapidity of our way of living, the excessive and unnatural strain upon the brains of business and professional men. To diminish this would be an almost impossible task. I can only suggest a diminution of working hours, the necessity for regular meals and habits, and means to prevent large cities from being over-stocked by the agricultural classes, who imagine themselves in these days particularly fitted for business and professional pursuits. We should abolish immoral entertainments, advertising quacks, so-called anatomical museums, and obscene and sensational literature, as far as possible.
Legislation should strictly regulate the sale of poisonous drugs, and the police should enforce the laws. Friends and relatives of excitable and nervous persons should be alive to the necessity of keeping from their reach razors, cutting instruments, and poisons. They should also endeavor, as far as possible, to prevent the formation of the opium-habit, self-administration of chloroform, and alcoholic indulgence.
Careful watch should be kept on all persons who go up into high public buildings, church-spires, and other eminences. Physicians should employ caution lest their patients should habitually indulge in some narcotic drug originally prescribed. The boards of health of the different cities cannot be over-zealous in suggesting means for the improvement of the dwellings of the poor. Air, light, and ventilation, should be provided, if possible, for these are absolutely necessary for nervous development and healthy cerebration. I have always considered the system of small dwellings, that has succeeded so well in Philadelphia and other cities, an inestimable boon to the working-classes. A healthier moral and physical tone is engendered, both by elevating the self-reliance of heads of families, and the abolition of moral contamination so prevalent in tenement-house life.
The establishment of bureaus and other agencies for procuring work for immigrants, freeing the cities from the surplus of these people, would prevent much desperation, misery, and self-destruction.