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.

    42/48 (page 40)
    battery and a little low diet will in all likelihood produce a speedy cure. When lumbago is complained of, it is best to humour the patient at the outset by examining the pulse, tongue, loins, etc., then to ask him whether he has observed any puffiness about his ankles lately, and end by requesting him to pull down his stockings to show them. As a rule, he will be taken off his guard by the interest displayed in his case, and will bend his back with an amount of alacrity which one really suffering from lumbago would envy, and, in fact, dare not attempt. But sometimes a fellow with his wits about him is not so easily caught, and then the wisest and most effectual course is to treat the case as genuine, and administer hot turpentine stupes. When a convict receives a sprain or fracture of any kind, he is very apt to make the most of it by protracting the cure; and should he receive a contused wound, he will sometimes render nugatory all other surgical aid by u doctoring” it himself. After amputation, he will even interfere with the stump, so as to induce necrosis, and thereby sometimes necessitate re-amputation a little higher up. After injuries of the former description, he should be discharged to light labour on trial, so soon as a reasonable time has elapsed to effect a cure and all swelling has disappeared. Should there be no subse¬ quent duskiness of the part nor return of swelling, he may safely be kept at his work, no matter how earnest his protestations may be that he is unlit to leave the hospital. In cases of wounds or ampu¬ tation, the dressings should be so applied that they cannot be inter¬ fered with without discovery. Self-mutilation is another feature of malingering, not at all rare in hard-labour prisons. Some time ago, a convict divided both tendines Achillis at Portland to disqualify himself for work ; and the medical officer of Chatham Prison writes, in his annual report for 1869, that u bruising of the hands between the buffers of railway carriages has been a very common mode of producing bad accidents, and thus gaining admission to the infirmary. Of the fracture, one death is recorded, which occurred from a prisoner purposely putting his foot under the wheels of a railway engine in motion ; his leg was dragged under the wheel, and amputation was performed ; but he died some days afterwards from tetanus.” A few cases belonging to this category, but not in any way serious, have occurred at this prison during the present year. All such cases are of course treated for the injury, and are justly punished when they are fit. VII. Under the heading of the integumentary system, remain to be considered factitious abrasions, ulcers, and abscesses. At one period soldiers were much addicted to producing tolerably fair imita¬ tions of such skin diseases as tinea decalvans, urticaria, erysipelas, and impetigo, by the use of various irritants and blistering sub¬ stances ; but now that the study of these diseases has become so much more general, I imagine that this variety of scheming has