How difficult it is for the medical man to persuade the friends of a person who has evinced a disposition to suicide, of the absolute necessity of his being confined and carefully watched! A physician, dining with a friend, met by accident a young lady who had exhibited, for a few days previously, a shrewdness of manner that attracted the notice of those with whom she associated. He also observed a wildness and incoherence about her ideas; but what particularly struck his attention was, the peculiar expression of countenance which so often denotes the presence of suicidal mania.[59] He felt convinced in his own mind that the lady meditated self-destruction; and so firmly persuaded was he of the fact, that he seriously spoke to the gentleman at whose table he was dining on the subject, and urged him, as he was intimately acquainted with the young lady’s family, to suggest the propriety of having medical advice, and of carefully watching the movements of the lady. This suggestion was treated with ridicule, and of course the subject was not broached again. Two days after the conversation took place, intelligence was brought that the lady had taken a large dose of laudanum, and had died from its effects! A little prudent caution might have saved the life of this poor unfortunate being.
In cases in which the disposition to suicide has been evinced, the patient ought to be carefully watched, and, under some circumstances, placed under restraint. Men who talk loudly of the effects of moral coercion, and who repudiate the idea of strait-waistcoats* &c., have had but little practical experience of the treatment of the insane. Moral discipline has done much good. Deeply should we regret to see the system which has been in force within our own recollection again introduced into our lunatic asylums. In endeavouring to avoid Scylla we have fallen into Charybdis. How many lives are lost in consequence of the patients not being properly secured when they have exhibited a desire to commit self-destruction.
A lady who had attempted to destroy herself was very properly sent to an asylum. Having expressed a determination to avail herself of the first opportunity for carrying her intentions into execution, she was most carefully guarded. She was never allowed to be out of sight; a trustworthy nurse always kept by her side; and in the course of time she was pronounced recovered. But as it was not considered prudent to send her home at once, she was separated from the other inmates of the house, and allowed to reside with the surgeon and matron of the establishment. Even under these circumstances it was thought better not to allow her to be wholly by herself, fearful that the disposition might again suddenly develope itself. She resided with the surgeon for some weeks, and appeared completely well. She expressed much astonishment when told that she had attempted her own life; she was apparently horrified at the idea. She was sitting with the matron one morning after breakfast; the surgeon was going round the asylum, when a child was heard to cry up stairs, as if it had received some injury. The matron immediately left the room; she was not absent three minutes, and when she returned she was astonished to find the young lady had vanished. Immediate search was made for her, but she was not to be found, when, looking behind the curtain in the parlour, the lady was discovered hanging to the cornice! In that short space of time she had succeeded in suspending herself, and was quite dead. Of course we cannot determine whether she had recovered, and this was but a sudden recurrence of the suicidal mania, or whether she had cunningly concealed her ailment for the purpose of throwing her attendant off her guard, and thus being enabled to effect her dreadful purpose. We should be more disposed to accede to the latter solution of the question, knowing the extreme cunning of such lunatics, and the ingenious stratagems they often have recourse to in order to accomplish any mischievous object they have in view.