THE MALINGERER'S TRICKS.

Hokitika Guardian, 7 September 1917, Page 4

THE MALINGERER'S TRICKS.

DODGING ” THE ARMY.

July G.

One hears of many men fit for military service frying to evade it by feigning disease. In Franco and Germany the military surgeon has always been on the look-out for malingerers ; in England while the Army was a voluntary one' the surgeon’s great task was to keep out men who concealed defects in their anxiety lo get in. Hence our doctors had no great experience of malingering and were not skilled in its detection when they were overwhelmed by the rush of recruits at the outset of compulsory service, and a man who wanted to deceive had a very good chance of succeeding. His chance of getting off henceforward will be very much less.

But the number of the worst type of malingering cases, those, in which perfectly healthy men simulate disease or some disabilitj 7 , is probably not so great as the number of men who really Jiave some ailment and who exaggerate it. Drs. A. Bassett .Tones and LI. ,T. Llewellyn, in their textbook “Malingering”- (Heinemann, 25/), say, “ Our o*n experience of soldiers in the present war leads us to the conclusion that * pure ’ malingering is uncommon”’ A malingerer must be extremely clever to succeed in liis deception now that the art of discovering simnJation is so perfect. The subject is a vast one, but a few examples of the doctor’s diagnostic, resources will show that he can seldom be deceived.

The malingerer’s special pitfall is his tendency to overact his part. “He sees less than the blind ; he hears less than the' deaf; lie is more, lame than the paralysed ” Generally there will be some discrepancy between his complaint and his actions. The doct ir therefore narrowly scrutinises how he pulls off his coat or shoes, how he sits down, how he walks when he thinks no one is observing him, and how he behaves when taken off his guard by s une clever ruse. -

Id' the malingerer complains of pain it is always severe, never leaves him alone ; but the doctor knows that there are few disorders in which pain is constant. The honest man has his had times and his good, lint the malingerer is never better, always worse. Very often, although malingerers study medical books and get the symptoms by 7 heart, they will alfect some symptom that is foreign to the disease simulated, and by encouraging them to dilate upon it the doctor scores easily*. If the complaint is a stiff shoulder the doctor starts an animated conversation while the patient takes off his coat ; usually 7 some mistake will he committed. If it is a stiff knee the

subject cf t he examination is asked to sit on a low chair, when he almost invariably bends the knee easily, revealing the fraud.

l'OCTOu’s FOUR MIiTUOn.S

The doctor 'employs deceit to combat deceit, and be has four main methods : lie misleads the malingerer, distracts his attention, induces ft state of bewilderment, and takes advantage of his ignorance of what the true symptoms are. When, for instance, a man complains that his arm is paralysed and keeps it hanging closely by his side, the doctor lays him face downward on a conch with the arm projecting beyond the edge; a paralysed arm would then fall down and point to the ground, but the malingerer will probably keep it pressed closely to his side, showing- that tlie muscles are perfectly healthy. When helplessness of a leg is simulated, the doctor may make a long examination of the sound leg, in the course of which he throws the whole of the weight of ihe malingerer on the so-called paralysed limb, proving its power to support the patient. Feigned deafness may be tested in the following way : If you stand behind a man at.d draw a stiff-bristled brush down the back of his coat, and then pass the palm of the hand down his back, lie can distinguish between them. If, next, you pasi your hand again down his hack while drawing the brush along his own clothes, he will say that he felt the brush. Now he does not feel the brush ; he hears it, and if he says he feels it he is not deaf. A person who feigns deafness is difficult to circumvent, but there are many other tests besides this, one of which is dropping a heavy weight behind him, when, if lie is a malingerer. he o.prdoes the deception and pretends he feels no vibration. The doctor is seldom bested by the man of normal mental powers, but has some trouble with degenerates such as convicts, tramps and beggars, whose malingering is a well-thought out scheme, and mosj trouble of all with the hysterical.