Suicide Research Before Durkheim

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Suicide Research before Durkheim Author(s): Robert D. Goldney, Johan A. Schioldann, Kirsten I. Dunn Source: Health and History, Vol. 10, No. 2, The Physician as Historian (2008), pp. 73-93 Published by: Australian and New Zealand Society of the History of Medicine Stable URL: http://www.jstor.org/stable/40111304 . Accessed: 28/08/2011 14:47Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.

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Suicide Research Before DurkheimRobert D. Goldney, Johan A. Schioldann, and Kirsten I. DunnThecasual readercould beforgivenfor assuming that there had been little systematicresearch on suicide beforethe workof the Frenchsociologist, EmileDurkheim,1 publishedin 1897. Thishistorical reviewdemonstrates thattherehad been extensive studies in theprecedingcenturies,addressingnot only the importanceof social factors, but also those factors which are now subsumed in the medicalmodel. Infact, some earlier reviewscan now be seen as morebalancedand comprehensive than that of Durkheim. In the twentiethcentury the predominant focus of suicide researchwas on the importanceof psychosocial factors, a focus a legacy of the influential whichwas undoubtedly workof Durkheim.Indeed, in 1971 A/vinAlvarez stated that the study of suicide had 'become the subject of intensive scientific research. The change began in 1897 with the publication of 's classic Suicide: A Study in Emile Durkheim '2and more Sociology, recentlyAlexanderMurray noted that, lIf the studyof suicide had its own era it would divide into two ages, before and after that book ... Le Suicide ... which, more than any other,establishedits subjectas a specialization.'? it is not unexpectedthat many believe Therefore that there had not been any substantial suicide research before Durkheim,let alone any which had addressedillness and biologicalfactors and their inter-relationship withsociety. This paper will explore suicide research before Durkheim. It will not address the writings of ancient civilisations, other than to acknowledge the work of Anton van HoofiP and Geoffrey Seidel,5 who reviewed suicide in Greek and Roman times, and that of A. Venkoba Rao6 who has written on suicide in ancient India. Rather, it will refer to several references fromHealth& History, 2008. 10/2 73

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the seventeenth and eighteenth centuries and then focus on the enormous increase in scientific research in the nineteenth century, research which culminated in excellent reviews of suicidal behaviour before the work of Durkheim.

Seventeenth CenturyIn 1637 the English clergyman, John Sym, published what Richard Hunter and Ida Macalpine referred to as 'the first English book on suicide,'7 entitled Lifes Preservative Against Self-Killing Or, An Vsefvl Treatise Concerning Life and Selfmurder. Whilst written from a theological point of view, Sym noted perceptively that 'Self-murder is prevented, not so much by arguments against the fact; which disswades from the conclusion; as by the discovery and removall of the motives and causes, wereupon they are tempted to do the same: as diseases are cured by removing of the causes, rather than of their symptoms.'7 Hunter and Macalpine also referred to early work by John Donne in 1646, which essentially discussed moral issues associated with suicide.

Eighteenth CenturyA bibliography published in Leipzig in 1806 by Christian Friedrich Ludwig8 referred to a number of eighteenth century books on suicide. These included those of M. Alberti from 1744: De autochiria occulta; Ant Louis from 1767: Memoire sur ime question pour distinguer les suites du succide de celles de Vassasinat\ P. Camper, from 1744: Gedachter over de Kindermoord: en Zelfmoord; and I. G. Burkhard from 1786: Briefe iiber den Selbstmord, among others, although access to the original texts is limited. In 1790 two volumes entitled A Full Inquiry into the Subject Suicide were published by the clergyman, Charles Moore.9 of These included a substantial section on gambling and suicide, an association referred to previously by Peter Andreas Heiberg,10 who reported an increase in suicide in Denmark following the introduction of 'number lottery' in 1771. Moore noted that suicide did not imply 'permanent madness,' although he added, 'Yet it may be allowed, that there is a sort of madness in "every" act of suicide, even when all idea of lunacy is excluded.'11 For

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those who may work in the forensic/legal setting and have to decide whether or not a suicide has been associated with psychotic illness, Moore's comment that 'Such distinctions of sanity and insanity are too fine spin to be just or equitable/11 is particularly pertinent. Indeed, it is doubtful if anyone in the subsequent two hundred years has described that challenge more elegantly. Moore was probably one of the first to comment on possible genetic factors, when he stated: 'But what adds to their wretchedness is, that this extreme dejection of spirits, this melancholy, this lunacy and propensity to suicide, like many other disorders, is not confined to the unhappy object in the first instance, but by attacking successive generations of the same family proves itself to be hereditary.'12 Moore observed that three quarters of suicides were by hanging, with males predominating two to one, and he was aware of the association between suicide and the 'excessive use of strong and spiritous liquors.'13 Some of his conclusions were somewhat speculative, such as his comments about suicide being perceived as 'the English malady,' because, as he so delightfully put it: 'the English are a nation so distempered by the climate, as to have a disrelish of everything, nay even of life.'14 Moore also referred to the concealment of suicide because of prevailing attitudes, and noted that he had 'received information from private hands . . . that the practice of suicide really abounds in France as much at least as in England.'15 He also expressed his disbelief in the suicide rate in Geneva being reported as eight times greater than in London, noting that 'the calculation of actual suicide in London cannot be made with the least degree of precision from the number of inquisitions taken by Coroners.'16 Moore clearly possessed an enquiring mind with a critical appreciation of the shortcomings of the available data.

Nineteenth CenturyIn 1807 the Danish physician Heinrich Callisen17 wrote that suicide was an illness,18-19and that model gradually gained in importance. Despite the clear description of Callisen, the medical model of suicide has been attributed primarily to the earlynineteenth century French physician Jean-Etienne Esquirol.20 However, Esquirol did not focus simply on a medical model,

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and German Berrios and Mostafa Mohanna21have stated that he had a broad view of suicide, consistent with contemporary theories which incorporate both illness and social factors in the postulated causation of suicide. There were also significant changes in public attitudes to suicide in Europe in the first few decades of the nineteenth century. In England this was probably associated with the suicide of Lord Castlereagh, or the Marquis of Londonderry, in 1822. He had been an influential and successful politician who suicided, almost certainly in association with a melancholic illness. He was not denied a funeral, as should have been the case, and that led to considerable public debate; debate which was given further impetus in 1823, when a twenty-two-yearold law student, Abel Griffiths, suicided and had the ignominy of being the last person to be buried at a cross roads. The rescinding of the law in regard to the treatment of the corpse of a suicide occurred soon after, and, certainly in England, this probably contributed to the emergence of more published work about suicide. In 1828 George Burrows22wrote extensively about suicide in his Commentaries on the Causes, Forms, Symptoms, and Treatment,Moral and Medical, of Insanity. He referred to it as 'a feature of melancholia,9 although he added that 'a doubt may naturally arise, whether it be not sometimes perpetratedby a sane mind.'23 Burrows referred to earlier French work, including that of Falret and Esquirol, and commented on the relationship of homicide and infanticide to suicide, the possibility that suicide was 'sometimes innate or hereditary,'24 and that suicide occurred in children.25 He provided comparative data between a number of European cities, demonstrating that the suicide rates were, in present terms, 60 per 100,000 in Copenhagen, 42 per 100,000 in Paris, and 20 per 100,000 in London.26 He also referred to work of Johann Ludwig Casper of Prussia, who documented 'mental alienation' and 'drunkenness and dissipation' as the two most common causes of suicide.27 Burrows stated that 'The medical treatmentof the propensity to suicide, whether prophylactic or therapeutic, differs not from that which is applicable in cases of ordinary insanity,'28and he was well aware of social influences, stating that 'periods of great scarcity and distress, and sudden revolutions, political or religious, are always active and universal agents in originating

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insanity.929He also ar