ArticlesSuicide by Hara-kiri A Series of Four CasesDi Nunno, Nunzio M.D; Costantinides, Fulvio M.D; Bernasconi, Paola M.D; Di Nunno, Cosimo M.D Author Information From the Department of Internal Medicine and Public Medicine, Section of Forensic Medicine, University of Bari, Bari (N.D.N., C.D.N.); and Department of Clinical Sciences and Sciences of Public Medicine, University of Trieste, Trieste, (F.C., P.B.), Italy. Manuscript received March 21, 2000; revised July 15, 2000; accepted August 2, 2000. Address correspondence and reprint requests to Nunzio Di Nunno, Dipartimento di Medicina Interna e Medicina Pubblica, Sezione di Medicina Legale, Università degli Studi di Bari, Piazza Giulio Cesare no. 11, 70124 Bari, Italy; email: [email protected] The American Journal of Forensic Medicine and Pathology: March 2001 - Volume 22 - Issue 1 - p 68-72 Buy Abstract The authors describe four cases of suicide by hara-kiri. This very painful form of suicide consists of self-inflicting a wound in the abdomen using a sharp instrument. It was first reported in 988 A.D. in the East but has now become rare in both the East and West. These four cases occurred over a 40-year period in the Trieste and Bari medicolegal area. In two of our cases the victims were afflicted with mental illness, whereas the other two suffered from depression. In cases of death by hara-kiri, it is important to establish a differential diagnosis between suicide and homicide; the presence of trial wounds (inflicted by the victim as a form of practice to overcome any hesitation before stabbing the abdomen with the cutting weapon) can prove very helpful. © 2001 Lippincott Williams & Wilkins, Inc.