MALINGERERS' TRICKS

New Zealand Times, Volume XLII, Issue 9792, 16 October 1917, Page 8

MALINGERERS' TRICKS

DODGING THE ARMY DECEIT EMPLOYED TO COMBAT DECEIT. One hears of many men fit for military service trying to evade it by feigning disease, says the “Daily Mail.” In France and Germany the military surgeon has always been ou the look-out for malingerers; in England while the army was a voluntary one tire surgeon’s great task was to', keep out men who concealed defects in their anxiety to get in. Hence our doctors had no great experience of malingering, and wore not skilled in its detection when they wore 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 he very, much less. But the number of the worst typo of malingering cases, those in which perfectly healthy men simulaste disease or some disability, is, probably not so great as the number of men who really have some ailment and. who exaggerate it. Drs A. nassott Jones and HI. J. Llewellyn,, in, their text-book “Malingering,” say, “Our own experience of soldiers in the present war leads us to the conclusion that ‘pure’ malingering is uncommon.” A malingerer must . ho extremely clover to succeed in his deception now that the art of discovering simulation 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 ’S his tendency to overact his part. “Ho sees less than the blind; he hears less than, the deaf; he is more lame than the paralysed.’’ Generally there will be some discrepancy between his com plaint and his actions. The doctor, therefore, narrowly scrutinises how he pulls off his ooat 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 oy some clever ruse. If 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 bad times and his good, but the malingerer is never better,' always worse. Very often, although malingerers study medical books and get the symptoms by heart, they will affect 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 ooat; usually some mistake will he committed. If it is a stiff knee, the subject of the examination is asked to sit on a low chair, when he almost invariably bends the knee easily, revealing the fraud. The doctor employs deceit to combat deceit, and ho has four main methods —he misleads the malingerer, distracts his attention, induces a. 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 couch with ■ the arm projecting beyond the edge; a paralysed arm would then fall down and.point to the ground, but tbe malingerer would probably keep it pressed closely to his side, showing that the 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 weight of the malingerer on the socalled paralysed limb, proving its power to support the patient. Feigned deafness may bo tested in the following way:-—lf you stand behind a man and draw a stiff-bristled brush down the back of - bis coat and then pass the palm of the hand down his back, ho can distinguish between them. If, next, yen pass your hand again down his back while drawing the brush along your own clothes, he will say that he felt the brush. Now, he does not Teel the brush: he hears it, and if , he says he feels it he is not deaf. A person who feigns- deafness is diffi-eul-t to circumvent, but there are many other tests besides this, one of which is dropping a heavy weight behind, when, if he is a malingerer, he overdoes the deception, and pretends he fe»ls no vibration. The doctor is seldom bested by the man of normal mental powers, hut has some trouble with degenerates, such as convicts, tramps, and beggars, whose malingering is a well-thought-out scheme, and most trouble of all with the hysterical.