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.

    45/48 (page 43)
    on hospital diet, his health having at this time suffered very con¬ siderably, and, the wound having healed slowly, he was discharged and began his punishment again. Three days after it reopened, and was nearly as bad as ever; and though he strenuously denied having tampered with it, on a strict wTatch being kept over him the officer in charge discovered, very neatly hidden in his cell, two inch pieces of pointed stick and one of stone, with string attached to them, that they might be placed and replaced at will within the wound.” So great is the detestation of many prisoners for work that it is only by having recourse to sharp repressive measures that the more frequent occurrence of cases of this description can be prevented, and hence it becomes the duty of the prison surgeon to report, with¬ out the least hesitation, any clearly-established instance of malin¬ gering, so that the culprit may be duly punished. Factitious ulcers and abscesses are, I believe, more generally resorted to in public works’ prisons than any other form of scheming, chiefly because they disqualify for work for the time being, and because the convict knows that unless the evidence against him is beyond doubt, he will be treated as an ordinary patient, and escape punishment altogether. There is another aspect of feigning occasionally exemplified in prison life, but which merits only passing notice-—I refer to feigned attempts at suicide. Hanging is the mode usually selected, and the feigned attempt is characterized by being made at some opportune moment when the proceeding is sure to be interrupted. Sometimes a prisoner threatens to commit suicide in order to be put under observation, but I have always found that he may be safely left to his own resources without the least risk of his putting his threat into execution. In bringing this sketch of feigned diseases to a conclusion, I am afraid that its practical utility may be somewhat curtailed owing to the special stand-point from which alone I could treat the subject clinically, and as a matter of personal observation and experience. But though the class of patients may vary, the same differential data are as generally applicable in the detection of feigned diseases as are physical signs and symptoms in the diagnosis of real disease ; and hence it is chiefly in the management of feigned cases that the circumstances of the patient take effect. It is true the prison surgeon possesses facilities for enforcing strict observation, and the carrying out of his instructions, that are not at the disposal of those engaged in general practice, but he is none the less bound to obey those dictates of humanity which secure to the suspected schemer the u benefit of the doubt,” and to the undoubted schemer protection from any kind of medical treatment bordering on the cruel or barbarous. EDINBURGH : PRINTED BY OLIVER AND BOYD.