MALINGERING

Dominion, Volume 10, Issue 3186, 10 September 1917, Page 6

MALINGERING

HOW ICEN EVADE SERVICE. In an interesting book, "Malingering, or the Simulation of Disease," Drs. A. Bnssett Jonea, M.8., and Lloweilyn J. Llewellyn, M.8., remind us that the malingerer, like the poor, has always been with us, and his art of simulation is probably rooted in the primitive biological instinct of mimicry which teaches animals to feign death when in danger, and, to take a particular and ralher pleasing example, suggests to the partridge the device of trailing " a wing, as if wounded and easily to be' caught, whpn a dog draws near her nest. "This assumption gathers weight," observe the authors of "Malingering," a comprchensive_ treatise on a many-sided and most fascinating subject, "when we recall the extraordinary attraction mimicry possesses for those of limited or abnormal mental development—the young child, the savage, the madman." Ancient literature, of course, is fertile in examples of malingering—as a rule adopted* by some "poltroon" (from pollex IrnnwrNs —the cutting off of the thumbs rendering a man useless for antique warfare) to evade military service.

Tantum cura potest, et ars doloris Desuit Coelius fingere podagram.

Such poetical justice has often been noticed, for there are many modern instances of malingerers who have con* trncted real diseases, sometimes ending in death, in the process of simulating disability by mechanical means %r by the use of drugs. Indeed, many instances of the kind havfe occurred in the present war.

Mr. Bassett Jones, who acts as "medical referee" to various insurance companies, and Mr. Llewellyn aro wellknown authorities on a form cf deceit which has become more common in this country since tho Workman's Compensation. Act was placed on the Statute-book. Moreover, the malingerer's parasitic art has progressed with the times; nowadays ho does not hesitate to attempt a counterfeit of the symptoms ot diabetes, jaundice, cardiac and pulmonary disorders, etc., nnd sometimes consults tho medical text-books in order to avoid mistakes which render detection easy. All this makes the task of exposing him more difficult for the medical practitioner, who is also debarred from using the drastic tests and threats—e.g., tho production of a red-hot ramrod—which could be prescribed in the old days whenever the' good faith of a military patient seeriied open to doubt. Another factor which complicates ', procedure in these enlightened days is the recognition of hysteria (which is so prolific in illvoluntary acts of simulation) as a rent disease. It is often very difficult to say whether or not hysterical mimicry is at work—the epigram of our authors that hysteria gives a parody, malingering a caricature, of a disease or disability, supplies the basis of discrimination. But in every case the means of. detection have been duly worked out, ?nd they havo only to be applied intelligently and with the necessary measure of patience (a medical referee must never allow himself to be hustled) to bring the offender to book.

Malingering to evade military service is not so common, we are glad to learn, in this country as in others v:hero conscription has been long -.stablished and traditional methods of securing exemption have been handed down from generation to generation. The (-'errnans being: a neurotic race, it is not surprising to learn that outbreaks of malingering in the Germnn Army have sometimes spread in such a way as (o suggest a psychical infection—a common enough phenomenon in the Middle Here and there in the 700 pages of their exhaustive survey, Mr. Bassett Jones and Mr. Llewellyn give curious exaninles of what may be called military malingering, which became a ' fine art'' in France during the Napoleonic wars. Readers of Erckmann-Chatrain's .stories will remember that vinegar-driliking was a popular method of stimulating illhealth araong_ those subject to conscription. And, in- recent years, Tirouardcl found that a,regular school for the education of malingerers .existed at Montpellier. It is a notable fact, however, that whereas Army regulations in Continental countries are in the main framed with the object of preventing the simulation of disease, in our /.rmy the viVilance of the authorities has been cliieflv directed against dissimulation, thai: Ts, the concealment of disease or disability. But demobilisation lias always produced a crop of malingerers; in 1839. for example, the result; of much successful imposture was that there as many soldiers on the Pension List as on tho Army Roll. This danger must be guarded against when our huge forces are disbanded. It is rather a- pity that this treatise does, not conccrn itself with tho spiritu-il malingering, so to speak, encouraged by the favour shown to the so-called "conscientious objector." Nothing has done morn to sap the morale of the nation th<in the creation of a privileged class of cowards.