Feigned diseases, their detection and management / by George Wilson.

  • Wilson, George
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: Feigned diseases, their detection and management / by George Wilson. Source: Wellcome Collection.

    44/48 (page 42)
    styptic colloid or collodion will suffice; if it be larger, say about the size of a florin, the part of the limb affected is strapped, and a coat¬ ing of styptic colloid applied over the strapping ; if it be larger still, a layer of carbolized cotton-wool is applied directly over the ulcer; this is brushed over with styptic colloid, and, over all, a bandage is applied which is also coated with the colloid. In some cases gutta-percha tissue may be advantageously employed in addition. In this way the dressings cannot be disturbed by the patient without detection, and they should not be removed until a reasonable time has elapsed for healing to have taken place. If there should be any tendency to the oozing of pus through the dressing, as will happen in large ulcers, it should be washed with a strong solution of carbolic acid, and a fresh layer of cotton-wool and another bandage be applied over the first dressing. Without going further into detail, I would strongly advocate Professor Lister’s plan of dressing in all wounds of whatever description, not only for its intrinsic merits, but because it is a safeguard against tampering in suspicious cases. In simple abrasions, or small ulcers of the leg which are undoubtedly artificial, a very successful plan of treatment is to insist on the limbs being kept exposed day and night outside the bed-clothes, in which case no dressing need be applied. Factitious abscesses are likewise of common occurrence amongst convicts. They are produced by inserting a small pointed piece of wmod or pin, covered with dirt, which is allowed to remain long enough to excite inflammation. The malingerer does not present himself until suppuration has set in, and the surrounding parts are highly inflamed. I have seen several cases of this description, and have found that the puncture is always discernible although it may have closed up. The pus, when the abscess is opened, has a dark sloughy appearance, and sometimes contains some fragments of foreign substance, which clearly establishes the character of the case. As an instance of this kind of malingering, I quote the fol¬ lowing from the annual report for 1869 of the medical officer of Portland Prison :—u A man under punishment complained of a sore in his foot. On inspection I found a small punctured wound on the side of the sole. On asking him how he came by it, he re¬ plied that a piece of wood ran into his foot while walking to the closet. Knowing that he must have worn a shoe at the time, and that, therefore, if his story were true, there must be a mark of the splint having passed through it, I examined it, and found no trace of this having been the case; and, though consequently disbelieving him, I gave him, as usual, the benefit of the doubt, and ordered him poultices, bed, etc. His foot became much worse, and highly in¬ flamed ; he began to be alarmed (which feeling I did my best to increase), and at last confessed that he had run a piece of stick into his foot. The wound was, therefore, laid open, and I extracted two pieces of wood, each about an inch in length. He appeared very penitent, and promised never to repeat the offence. He was placed