ON FEIGNED DISEASES, AND THE DETECTION OF THEM.
Galen, we believe, is the only ancient author who has treated professedly of the detection of simulated diseases. He begins his short treatise on this head with remarking, that persons feign diseases from various motives, and that it is expected the physicians should detect such impostures. That, for example, inflammation, erysipelas, and œdema, when produced artificially, ought to be distinguished from the same diseases when they originate in constitutional causes. He adds, that hæmoptysis, hæmatemesis, and bloody discharges from the bowels, are often simulated. Hæmoptysis is simulated by opening a vein in the gums, and sucking blood from it while one affects to cough. Others, he says, affect dementia, fatuity, and insanity, all which cases the vulgar expect that the physician should detect. Inward pain, such as that of colic, he had often known to be simulated, and relates briefly an interesting case in point. He remarks, that experience and natural sagacity will enable a man to expose all impositions of this nature. He gives a very interesting account of the manner in which he detected the nature of a swelling at the knee, that had been produced intentionally by the juice of thapsia (thapsia garganica, deadly carrot?) Feigned inward pains, he remarks, may often be distinguished from the real by the aversion which the malingerer discovers to swallow medicines, which he would be anxious to have given him if he were actually in acute pain; and adds, that the state of the pulse, and the other symptoms of intestinal diseases, will assist in making the detection. (Quomodo coarg. sint qui fing. se Ægrot. t. iii, 388, ed. Basil.)