Case CLXV

A lady had brought up an orphan girl, whom she treated with great kindness. Some rabbits were given into the charge of the child. An idea came into her head that if she killed them she would be driven away. The probable consequences of this evil action acted so foroibly on her imagination that she finally heard a voice desiring her to kill these animals. The more terrified she became at the counsel, the louder rang the voice in her ear, for she thought of nothing else. Thus continually tormented, and not being able to escape from her idea, she thought to rid herself of it by yielding, and the rabbits were destroyed. Long afterwards this unhappy girl committed suicide.*

Every one must have occasionally remarked the sudden rise of painful ideas in the mind, whose persistence is really strange. It seems impossible to drive them away. The force of evidence can alone triumph over them. This singular state lasts sometimes several days, and particularly with nervous persons. But if by some means the idea is not repulsed it becomes fixed, and the organization is subdued beneath its tyrannical power. The irresistibility of certain ideas is proved by a thousand examples. The writer of Pinel threw himself into the Thames; and when he was asked to give a reason for this act, he replied that he had been driven to it in spite of himself. The barber spoken of by Forbes, made a gash in the throat of a person whom he was shaving, but he could not explain why he did it, etc.†

The examples of this class are numerous, and there is no doubt that insanity and hallucinations make up a great number of the list of suicides exhibited yearly in the public records.

* Chardel, Eeeai de Psychologic Physiologique, 3d edition, 1 vol. in 8vo. Paris, 1844, page 205.

† Boileau de Castelnau, De la Folie instantanee au point de vue medico-jndiciaire (Annal. Med. Psych, t. iii. ann. 1851, pp. 307 and 479).

In each of the cases just cited, the cause of suicide was evident. But it is not always thus; if the clerk had cut the throat of his wife and had then drowned himself, it is probable this bloody tragedy would have been attributed to any but the real motives.

Again, suicide may be occasioned by a voice apparently from the street, calling to the hallucinated; he, hastening to obey the call, will be precipitated from the window, under the idea that he is walking out of his room. A madman imagines that he sees a bright chariot waiting to transport him to heaven; he opens his window, walks quietly out to mount the chariot, and falls on the pavement.

. Suicide often occurs in maniacal delirium and acute delirium, which accompany febrile affections. When it has been possible to discover the origin of these catastrophes, it has constantly been found that they were the result of hallucinations and illusions, which engendered panic terrors; and that there are, as regards motives, fewer suicides than attempts, induced by a sentiment of self-preservation, to escape from chimerical dangers. I remember, says Marc, a patient attacked with typhus, when that disease raged in the city, who would have thrown himself from the window had he not been prevented. When this delirium was reduced, he recollected perfectly that he thought himself pursued by a horrible phantom, from which he was endeavoring to escape.*

If hallucinations be a cause of suicide, they no less frequently occasion attempts against the lives of others. Sad and melancholy ideas, and fear, concur singularly in producing these acts. The fear of the police and of the pursuit of enemies, has in a great measure taken the place of the dread of the devil and of spirits; although, for several years past, demonomania has again dawned on the horizon. Nothing is more common than to be consulted on the cases of madmen who think themselves a mark for persecution, and whose death is being sought for by poisoning or assassination. I was called to attend a lady, who appeared in full possession of her reason. She said to me, with the greatest coolness: " Sir, eight days since, in going to mass, I perceived that I was followed by ill-looking men. On leaving the church, I found three of them lying in ambush in the Rue de l'Ouest; one attempted to rash upon me. The day before yesterday, the porter of my house placed a ladder against the wall, in order to enter my room; but on seeing me, he retreated. Everybody is trying to harm me; I am surrounded with assassins." This variety of monomania almost always exists with hallucinations of sight and hearing.

* Mare, de la Folia consideree dans sea rapports avec les questions medico-judiciaires, 2 vol 8vo. Paris, 1840, t ii. p. 156.

The patients who are tormented by these ideas, imagine that improper words and insults are whispered into their ears. They assert that they are spoken ill of, and looked on askance. In order to escape these annoyances, some seek solitude, change places incessantly, and endeavor to conceal their traces; others, of a bolder character, face their imagined enemies and challenge them, who no doubt fall under the blows of these madmen.