Evening star. [volume] (Washington, D.C.) 1854-1972, 1905-11-28
SHAMMING DISEASE
TRICKS PLAYED TO AVOID WORK
OR WIN SYMPATHY.
One Man Feigned Inconsistencies for
Thirteen Months-Simulation
Of insanity.

From the Lancet.
The art of shamming disease has reached
a high level of perfection. This, Is mainly
to be attributed to the fact that the re-
wards of proficiency are great. Fresh IN
the minds of all is the recent case OF
professional beggar In the city of London
whose voluntarily paretic limbs stirred up
the lively compassion of the passers by,
even of the poor, so that charitable gifts
flowed into his ready palm.
This case has excited some little atten-
ton. chiefly because the police have prose-
cuted him successfully, but he is only one
of very many.
1t Is. however, in connection with the
naval and military services that the art OF
malfngery finds It's chief exponents.
In the days when it was necessary for
a soldier 10 bite off the end of the cartridge
in loading his musket it was no uncommon
event for a man to have one or more teeth
extracted or filed down so as to obtain
exemption. There is an old tale, in all prob
abiuty|trae- that illus trates well the trouble
which such a man will take to escape from
military service. A soldier was seized with
paralysis of the right arm; the loss of
power came on suddenly and without OBJ
VlouS cause. Malingering was suspected,
but all the efforts of the surgeon of the
regiment were unavailing, no proof could
be obtained that the paralysis was feigned
The man was examined by two medical
boards and ultimately he was given his
discharge. AS he went off from the bar
racks on the top of the coach Git was in
the days before railways he waved a
hearty goodbye to his comrades with his
paralyzed arm.
Strategem of a Sailor
Probably the best example of the perse-
verance which men will display in the at
tempt to leave service which they detest
Is to be found in case under the care Of
Cline. The patient was a sailor in the Brit
ish navy, and it is worthy of note that he
was pressed" man. He fell on his head
ana slght depression of the skull was
produced. He Immediately became uncon-
scious and all efforts to rouse him failed
he lay quietly In his hammock and never
moved. He seemed deaf to all sounds and
at no time uttered word. He was able to
swallow food, both solid and LIQUID and
indeed he made signs with his lips and
tongue when he wanted nourIshment He
was brought back to England but no inn
ploFenieht followed. and the Unconscious
ness lasted for thirteen months Then n
was resolved to raise the depressed nortion
OIL the bone. Flaps were made, a trephine
was applied and the bone was cut through
An elevator was then introduced to raise the
polle ana as the bone was lifted up con-
seriousness suddenly returned to the patient
ana ne spoke. At the time of the operation
most or the onlookerS accepted the "a SO as
sehulie, out no one would nowadays ven
lure TO support the idea that the natient
really lay unconscious for thirteen months
suddenly resaintng consciousness on re-
moVaI of the depressed bone There can he
no aouot mat the man was a malinserer
and adopted this arduous method Of laavina
service into which he had been forced o
me amount of pain and discomfort
Whlch maiingerers are willing to endure IA
OBTAIN their discharge is almost incredible
but the facts are well attested A Ii,,b
held a i've
months, and not even the application OF
the actual cautery has sufficed to move
II. Many men have chopped off soma
myers and claimed that it was an acct
dent ~ 4 ''00t
Mental arrangement of one sort or an
other Is a favorite form of ma.lingerv. hut
the results usually resemble the popuIar
or stage idea Of insanity rather than the
true products of mental alienation. It is
hot uncommon for the malingere~ % COM
pine two forms of insanity, and this ma "
De OF value in detection. Still, it is often
very difficult to be certain that natiant
Is shamming. There are. however 500
Phenomena which cannot be simulated. II
Is impossible for sane man to imita :
successfully the persistent insomnia which
often occurs in the insane; the imnostor
cannot put off sleep beyond the second or
third day. "a
Reason for Malingering.
Another frequent motive for maIineersng
of obtaining money but merely to gain
notice Simulated joint affections are not
rare and there are many other forms.
These cases merge imperceptibly into hys-
terfa, and indeed in many hysterta is COM
bined with the wish to deceive 1t Is not
improbable that IN some of these patients
Iher6 Is certain degree of cutaneous am
estheslal winch rerders the standardization
more easy or accomplishment, There are
other causes for Stimulating disease or in
jury. Sometimes 1t Is done to avoid pun
ishment, sometimes to wreak vengeance ON
another person who Is accused of having
inflicted the injury. To obtain compensa-
lorl Tor injury in a railway accident sew
eral LESSONS may be simulated and esne-
cially those obscure and Ill defined con-
ditions which have been attributed tn
spinal concussfon"
Sad to relate, many of the attempts to
initiate disease have led to serious and ir-
reparable results, and even to death itself
man excited an ulcer in his leg by
means OF a copper coin, and later gran
creme appeared, necessitating amputation
below the knee. In endeavoring to excite
hemoptysis man swallowed a cork into
which pins had been inserted. He spat up
blood and became very emaciated and then
suddenly died from hemorrhage. At the
Microscopy 1T was found that the cork and
pins had lodged at the junction of the
pharynx and esophagus and that the pins
had liberated through the esophagal walls
and had opened into the common carotid
artery on both sides
The detection of malingering Is often no
easy matter, and no general rule can be
laid down which will be applicable to all
cases. The mere threatening OF severe
methods of treatment is sometimes sue
cessful, but frequently fails. The threat of
the application of the actual cautery has
cured paralysis. but cases have been re-
corded where malingerers have endured the
cautery on several occasions. A man who
simulated blindness was placed on the edge
of a jetty and told to walk straight for
ward. He stepped out and fell into the
water, for he knew that those who were
testing him dared not let him drown. In
another case, however, a man who seemed
to have paralysis of an arm allowed the
amputating knife to be placed close to It
without ffinching, but when thrown into
the river he struck out with both arms
and swami back,
A very useful method of detection is the
suggesting OF new signs and symptoms to
the patient. The surgeon remarks, say
In the case of paralyzed arm, In the hear
ing OF the nlalingerer that 1t is strange that
the little finger is fexed-it ought to be
straight. In all probability at the next
visit the little finger will have assumed
the suggested position The more outre
and irregular the fresh symptoms sug-