The sun., 1905-08-13
WAYS OR SHAMMING DISEASE

~ AAN VI N0AMmAANV OANAANA
TRICKS PLAYED TO AVOID WORK
OR WIN SYMPATHY.
One MAN Fcisned Unconsciousness for 10
Months-Eimulstion Of Insanity Often
Tried but Rarely with Sucoess-Ways
That Are Used to Catch Fakers.
The art Of shamming disease has reached
Q high level Of perfection. This is mainly
to be attributed to the fact that the rewards
Of proficiency are great. Freeh IN the minds
Of all Is the recent case Of o professional
beggar In the city Of London, whose volun-
tarily paretio limbs stirred up the lively COM
passion Of the passerB by, even Of the poor,
90 that charitable gifts flowed into his ready
palm.
This oase has excited some little atten-
ton. says the Lancet. chiefly because tho
police have prosecuted him successfully,
but he Is only ono Of very many.
1t Is, however. In connection With the
naval and military services that tho art Of
malingery finds its chief opponents.
In the days when 1t was necessary for
q soldier to bite OF the end OF the cartridge
In loading his musket 1t was no uncommon
event for a man to have one or moro teeth
extracted or fled down 80 as to obtain
exemption. There Is an old tale, In all
probability true, that illustrates we'll the
escape from military service. A soldier
was seized with paralysis Of the right arm,
tie loss Of power came on suddenly and
without obvious cause Malingering was
suspected, but al the efforts Of the surgeon
OF the regiment were ,navailing, 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 of from
the barracks on the top Of the coach Ut
was in the days before railways) he waved
q hearty good-by to his comrades with
his paralyzed arm.
Probably the best example Of the per-
severance which men will display In the
attempt to leave service which they
detest 10 to be found IN q case under the
care Of Cline. The patient was sailor
in the British navy, and 1t is worthy Of
note that he was pressed man. He
fell on his head and . slight depression
Of the skull was produced. He !mmedi-
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
tongue when he wanted nourishment.
He was brought back to England, but no
Improvement followed, and the snoon-
soiousness' lasted for thirteen months.
Then 1t was resolved to raise the depressed
po9a Of ns soDd eoDn n9s an5 bs we're sens n1d
cut through. An elevator was then intro
duced to raise the bone, and as the bone
was lifted up consciousness suddenly re-
turned to the patient and he spoke. At
the time Of the operation most Of the on
no one would nowadays venture to sup
port the idea that the patient really lay
unconscious for thirteen months, suddenly
regaining consciousness on removal OF the
depressed bone. There can be no doubt
that the man was malingerer and adopted
into which he had been forced.
The amount OF pain and discomfort which
malingerers arc willing to endure TO obtain
their discharge is almost incredible. but
the facts are well attested A limb has been
held in fixed position for many months,
and not even the application Of the actual
cautery has sufflced to move it. Many
men have chopped of some fingers and
claimed that 1t was an accident.
Me1tal @ deranEemeat @ OF 4 one 7; sort sort or snother
results usually resemble, the popular or
stage idea Of insanity rather than the true
products OF mental alienation. 1t ia not
uncommon for the malin gerer to combine
two forms Of insanity. and this may be Of
value in detection. Still, 1t is often very
shamming. There are, however some phe-
nomena which cannot be simulated. It is
impossible for sane man to initiate suc-
cessfully the persistent insomnia which
often OCCURS in the insane; the imposter
cannot put Oh sleep beyond the second or
Another frequent motive for malingering
is to attract attention, not for the purpose
Of obtaining money but merely to gain
notice. Simulated joint affections are not
rare and there are many other forms. These
and indeed in many hysteria is combined
with the wish to deceive. 1t tis not improba-
BILE that In some Of these patients there is
q certain degree OF cutaneous anesthesia
which renders the set mutilation moro easy
for Stimulating disease, or injury. Some-
times 1t is done to avoid punishment some-
times to wreak vengeance on another person
who is accused Of having inflicted the injury,
To obtain compensation for injury In .
sna esne sexeel tbss esons may be
Ill defined conditions which have been at.
tributed to spinal conoussion.'
Sad to relate, many. OF the attempts to
initiate disease have led to serious and irrep-
arabic results, and even to death itself,
A man excited an ulcer In his leg by means
Of copper coin, and later gangrene ap-
peared, neoessitating amputatIon below the
knee. In endeavoring to excite hemoptysis
a man swallowed cork into which pins
had been inserted. He spat up blood and
became very ernaoiated and then suddenly
died from hemorrhage. At the Microscopy t
was found that the cork and pins had LODGED
at the junction Of the pharynx and esopRa-
gus and that the pins had liberated through
the esophG gal walls and had opened into lie
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 nero threatening Of severe
methods Of treatment Is sometimes success.
hui, but frequently fails. The threat Of the
application Of the actual cautery has cured
paralysis, but cases have been recorded
where malingerers have endured the cautery
on several occasions. man who simu.
ated blindness was placed on the edge Of q
|etty and told to walk straight forward. he
stepped out and fell into the water, for he
Knew that those who vere testing him dared
nnk l>t HIM deN~n Tn snnAh~c No.