Feigned diseases, their detection and management / by George Wilson.

  • Wilson, George
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: Feigned diseases, their detection and management / by George Wilson. Source: Wellcome Collection.

    29/48 (page 27)
    In discussing further the different varieties of feigned diseases, it will be convenient to classify them as follows:— I. Feigned and factitious diseases of the circulatory system, II. 77 77 respiratory ,, III. 77 77 digestive „ IV. 77 77 urinary „ V. 77 77 generative „ VI. 77 77 locomotive „ VII. 77 77 integumentary „ I. Feigned disorders of the circulatory system are comparatively rare. I have met with a few cases, in which convicts, preparatory to the hospital visit, if treated in separate cells, have accelerated the pulse and produced profuse perspiration by covering their heads over with the bed-clothes and breathing rapidly for some time. If the tongue has been previously coated with whiting from the walls— a practice not at all uncommon—such cases may be mistaken for febricula; but their real nature is easily ascertained by visiting them at an unusual hour. Palpitation and irregularity of the heart’s action have sometimes been induced by taking doses of the veratrum album or white helle¬ bore; and, according to Gavin, so widespread was this practice at one period amongst the Royal Marines, that many were invalided before it was detected. The dose was about ten or twelve grains, and was repeated until symptoms of a somewhat grave nature set in—such as incessant vomiting, frequent tremors, clammy sweats, weak and irregular pulse, followed by violent and interrupted action of the heart. In like manner, the heart’s action has been intention¬ ally lowered and seriously disturbed by over-dosing with digitalis, tartar emetic, tobacco, etc. While a state of syncope is often feigned by hysterical females, mendicants, and others, it is next to impossible to simulate its char¬ acteristic symptoms, and hence detection is easy. Indeed, in almost all cases of induced or simulated disorders of the circulatory system, a careful examination with the stethoscope, after the patient has been allowed to remain quiet for some time, will make clear their character; and when drugging is suspected, it is requisite that the patient be kept so far secluded as to prevent him from obtaining any further supply. II. The symptoms of diseases of the respiratory system most commonly feigned are, pain in the chest, cough, haemoptysis, dys¬ pnoea, and aphonia. With regard to the first of these, it is import¬ ant to bear in mind that it often exists independently of any lung affection, and may be of considerable severity. For example, it may be purely muscular—as in the case of persons who are accus¬ tomed to work at low benches or desks; or it may be sympathetic,