_Homicidal Patients._--Patients are sometimes both homicidal and suicidal, and sometimes they are inclined to only one of these forms of violence. Homicides are not of frequent occurrence in an asylum. The better the care the less is the liability to homicide. But there are always a great many homicidal patients, and many more who have delusions and ideas that may cause such tendencies to arise. Many patients are homicidal merely from violence and frenzy, and without any settled plan, any fixed delusion, or intense suspicion. They may attack others suddenly and furiously; they may commit the act while trying to escape, or it may be the result of the violence of acute mania. Other patients become homicidal under the desire to protect themselves from supposed assaults. They may think a person who is approaching them is coming to kill or torture them. Others are homicidal from any of the ideas of persecution and suspicion that have just been spoken of. Sometimes patients hear voices telling them to commit the act, perhaps it is God's voice commanding a father to offer up his only son as a sacrifice, or a mother to kill her little children to save their souls, or keep them from some misery or crime that awaits them. Patients may think themselves God, or a king, or ruler, and therefore have a right to take life. Homicidal patients are often among the quietest, and are found in the quiet wards. They frequently lay careful plans, are secretive, and only try to commit the act when they feel sure it will succeed. Patients who are homicidal should be especially watched. They should, if possible, be kept employed, but never given tools that may become weapons. They should sleep in a room by themselves. All persons against whom they have delusions should be warned. Patients against whom they harbor suspicious or homicidal ideas should be separated from them. Attendants should remember that a mop, a pail, or a chair, may become a dangerous weapon, or that a knife, scissors, or a sharpened piece of iron or tin, may make a fatal wound. _Suicidal Patients._--Patients with this tendency will generally talk freely of their suicidal ideas, tell why they wish to commit it, what provokes the idea, and how they would do the act. They are frequently grateful for the care bestowed to help them resist the impulse, and will sometimes tell the attendants when they feel the suicidal ideas coming on, that they may be the more surely watched.