The predecessors of Durkheim, Freud, and Kraepelin, distrusting explanations based on specific causation, had assumed that suicide like other diseases was a consequence of the interaction of emotional, constitutional, and habitual imbalances. The way a person lived, ate, and felt was viewed as inseparable from the course and outcome of any disorder. For the nineteenth-century physician, the moral issues that suicide raised could not be isolated from its constitutional components. Thus, those who exhibited suicidal tendencies were subjected to an amalgamation of pharmacological, social, and psychological interventions, which practioners labeled the moral treatment.

By the 1890s, however, the consensus about the causes of suicide became unglued as a bacteriological medicine and the rise of the social sciences jointly served to call into question eclectic diagnoses. The renewed doctrine of specific causation of disease quickly spilled over into a constellation of explanataions for social behavior. The rise of specialization, which followed the bacteriological revolution of the 1880s, made the moral treatment appear scientifically suspect.

The goal of American Suicide is to demonstrate how the apparent contradictions among sociological, psychoanalytic, and neurobiological explanations of the etiology of suicide may be resolved. Only througha reintegration of culture, psychology, and biology can we begin to construct a satisfactory answer to the questions first raised by Durkheim, Freud, and Kraepelin.