The highest rate of suicidal propensity was found in cases of melancholia, a proportion of 57, compared to mania 21, ordinary dementia 16, senile dementia 15, and idiocy 8. The states of family life gave these proportions: marriage 32, celibacy 24, and widowhood 29, and of married persons, more females than males. The Report also subdivides these cases with respect to the causes assigned for the insanity; the following were the most fertile causes, with the relative proportions:─ Domestic trouble, 9·7 (twice as many females as males); adverse circumstances, 6·0; overwork, worry, 7·5; religious excitement, 3·6; love affairs, 1·9; nervous shock, 1·4; alcoholic excess, 12·1 (nineteen males to six females); sexual excess, 0·5; sunstroke, 0·7; venereal disease, 0·3; self-abuse, 1·0; accidents, 3·2; pregnancy and parturition, 3·6; change of life (females), 2·9; privation, 2·0; old age, 3·0; bodily disease, 11·0; hereditary transmission, 22·8; and previous attacks, 15·8. In England it is not practicable to form any reliable estimate of the true proportion of insane suicides, as compared with those occurring from disease and mental trouble. On the Continent an attempt is made in most States to assign the proportion; but it is easy to point out the difficulty of the task and the numerous errors that are liable to creep into such calculations. The following rates per 1,000 suicides have been published in the “Asylum Journal,” vol. 27: France, 300 insane per 1,000; Belgium, 470; Prussia, 333; Italy, 343; and Bavaria, 342. M. Prévost, in a learned investigation of cases of voluntary death, estimated that 18 per cent. occurred in insane persons. I have made careful investigation into all the cases of suicide which I have observed, and all those cases upon which I have held inquests, as the Deputy for Dr. Danford Thomas, in Middlesex, and I have found that in 20 per cent. only had the deceased ever exhibited symptoms of insanity obvious to the friends and relations. The suicide rates of the great German lunatic asylums are higher than those of our English ones. Dr. Löwenhardt, of the great asylum at Sachsenburg, states that the average number of suicidal deaths in that institution is 5 per cent., a large proportion; for in the asylum of Illenau 3 per cent. only killed themselves, and in the asylum of Halle, only 1·7 per cent. The varying rates of suicidal death in asylums depend very much on the qualities of the nurses on the staff, and on the relative number of patients attached to each attendant, for nothing but a constant and lynx-eyed survey will prevent the self-destruction of a large proportion of lunatics, when they have a wave of suicidal tendency passing over their minds. CHAPTER XV. EPIDEMIC SUICIDE; SUICIDE FROM IMITATION, AND DESIRE FOR NOTORIETY. In relation to lunacy and mental disturbance, I must now refer to the question of Epidemic and Imitational Suicide.