Several worthy members of the medical profession have sought in suicide a refuge from the mental pain and anxiety caused by unjust accusations; a doctor is desperately liable to such charges, which are usually brought for the purpose of extorting money, or for revenge. There was a sad example in 1865 of a surgeon at Salisbury, and one two years ago at Hounslow; and since then at Kensington a much respected medical practitioner stooped to self-destruction when a criminal charge was brought against him, which subsequent investigation showed to be without the legal and medical facts necessary to support it. I believe that if a calculation could be made of the _proximate_ causes of suicide in England, the most common causes would be found to be misery, despair of success in life, and remorse for crimes, misdemeanours and follies. In concluding the consideration of causation, I remark that Morselli and others have said, that in the ancient world political fanaticism had its era for causing men to end their lives; in the Middle Ages religious fanaticism held its sway as a cause of suicide; and I should add that in modern times it is the high pressure at which we live, the difficulty of obtaining a livelihood, and the forced education of the young, which fills our asylums and swells our voluntary death-rate. CHAPTER XVIII. THE MEANS OF SUICIDE. It is a somewhat curious fact, considering the immense number of feasible means of terminating one’s existence, that there should be such a small number of methods in constant use. To enumerate the possible means which should fulfil the necessities of the case, viz., to be certain and be speedy, would take too long, and would be unnecessary. The means that are used daily are practically very few; the following eight methods include almost every case: Hanging, drowning, shooting, cut throat and other wounds, falls from a height, placing the body in the path of railway trains and other vehicles, poison, and suffocation by want of air, or poisonous gases. Voluntary starvation, which was common in ancient Rome, is now almost unknown. The relative frequency of these means is found to vary in each country, and in each country varies with age, sex, occupation, and opportunity, but these several numbers are very constant year after year. Whenever we find the use of an exceptional means, which causes prolonged or more exquisite torture, we constantly find evident traces of insanity─(Morselli). The sane man may kill himself, but he endeavours to do it as easily as may be.