Deafmutism: Explained by patient as malingering.
Case 463. (Myers, September, 1916.)
A pure malingerer, of set purpose, initiates a quasipathological condition which he will discard when he has gained his end or when he is assured that he is unobserved. Malingering in the field of speech is rare. A private, 26, one year in service, three months in France, entered a base hospital, deafmute for nine weeks. He wrote: “I should be very happy if you can do anything for me. I cannot give a very clear account of what happened, as it is sometime since. I remember retiring from Hill —— with some more to some trenches, and in the open we were shelled and I lost touch with our chaps or else they were killed. I remember a great concussion and finding myself on the ground, and a soldier dragged me up and we ran for the trench. I was very thirsty and I ran down the trench to get some water. I met one of our chaps and tried to ask him for some, and I could not make him understand. He only smiled at me. The man who picked me up took me to an officer who was sitting on the edge of the trench and tried to make me understand, and then he sent me with this man to a dressing station, and from there I have been to different places, the names of which I do not know, except the last place, No. — Convalescent Camp. I have been there about two months——”
He seemed anxious to get well. He could not understand what was said. Induced anesthesia caused no phase of excitement, and the patient failed to regain his speech. He was evacuated to England. Three months later the patient thence wrote the following confidential letter from a Convalescent Home. “Sir,—I regret very much to inform you that I was imposing upon you.——I may state that I was physically unfit for the Front.——During the whole time of training my pay was chiefly spent in tonics and drugs, but I kept going as I was determined to see what it was like at the Front.——I have written this——that your ‘notes’ on cases will not suffer any detrimental effect through my imposture.——I have not got my discharge yet, but shall stick out for it. I ‘speak’ but do not ‘hear’ very well.—” He was in two hospitals for functional nervous disorders in England, but in neither institution was he regarded as a malingerer.
Re hysteria explained by the patient as malingering, Chavigny discusses what he calls sursimulation. The physician must not fall into a permanent state of suspicion, and especially must not reveal his suspicions to the accused or to the bystanders. Chavigny quotes a French soldier whose letter to his wife was intercepted, stating that he was going to feign deafmutism to secure his discharge. Before he had succeeded in doing so, however, he suffered Shell-shock, and got a true hysterical deafmutism, which showed no signs of malingering whatever.
Deafmutism: Appearance of malingering.
Case 464. (Myers, September, 1916.)
A stretcher bearer was seen by Lt.-Col. Myers two days after admission to a base hospital. Stolid looking and mute, he had nevertheless talked in his sleep, had written a few words about “shells coming over,” and understood what was said to him. Lt.-Col. Myers’ notes run, “He puts out his tongue and closes his eyes and holds out one hand when I ask him to do so, but gets stupid (as if sulky) when I ask for the other hand. He will not hear any more. Next day quite deaf, and the following day light anesthesia with ether caused a return of hearing and of speech, with repetition of syllables to request on the way to deeper anesthesia. On awaking he cried as he was induced to resume his speech, and complained of pains in the head.