A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 3).
- James Copland
- Date:
- 1834-59
Licence: Public Domain Mark
Credit: A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 3). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
![this subject in the Cyclopedia of Practical Med- icine state that a case of enormous enlargement of the thigh and leg, resembling elephantiasis, was sent home from India to be discharged. A ligature was discovered, and, upon its remo- val, the swelling gradually subsided. The de- tection and prevention of such cases cannot be difficult. 49. Ulcers artificially caused were remark- ably frequent in both navy and army during the last war. They were generally produced upon the legs by various caustics or irritants, by friction with sand, by quicklime mixed with soap, by compression with metallic or other bodies, and by mineral acids. Arsenic, corro- sive sublimate, tobacco, &c, have also been used for this purpose. Mr. C. Hutchison found a halfpenny between the muscles of a leg which he removed in consequence of extensive caries of the tibia following artificially-formed ulcers. Intentional ulcerations are distinguished from the real by their borders being less callous, their surfaces more superficial and less painful, and their disposition to heal, when secured against tampering, much greater, owing to their not originating in, or accompanying, con- stitutional disorder, as in the case of real ul- cers. In order to prevent this species of de- ception, Mr. C. Hutchison had recourse to a wooden box, in which he locked up the whole limb; all other means, as marked or sealed bandages, &c, having been found insufficient against the ingenuity of malingerers. 50. The Urine presents various disorders in respect of its characters and of its excretion, which have been artificially produced or feign- ed by persons desirous of escaping from the public services, and by hysterical females. In- continence of Urine was often simulated by sail- ors and soldiers. The circumstance of this disorder occurring frequently in this class of persons, who are mostly young, or in the vig- our of life, should excite suspicions of its real- ity. The simulator generally chooses the cir- cumstances and place suitable to his purposes in allowing the urine to escape. Laurent and Percy state that the glans penis is always pale and shrivelled in real incontinence, and that the urine never comes away in a stream. M. Fodere, finding that this complaint was becom- ing epidemic in a regiment, and that blistering the perinaeum and other means did not cure it, directed the penis of every patient to be tied and the knot sealed, none but the person guard- ing them being allowed to remove the ligature. The penis was observed from time to time, to ascertain whether or no distention above the ligature existed, and whether, when it was re- moved in order to urinate, the discharge took place guttatim, as in real incontinence, or in a stream. The expedient succeeded, and the epidemic vanished (vol. ii., p. 481). Percy and Laurent prescribed twenty lashes to the loins, with the avowed object of exciting the weakened organs. It was unnecessary to di- rect it to a second case. An army-surgeon directed a cold plunge-bath twice a day with equal success; and Mr. Hutchison, Mr. Com- yns, and Dr. Hennen caused a strong opiate to be given at night, and the length of time the urine was retained during sleep to be watched, for, in real incontinence, the urine passes away after a short time under all cir- cumstances. The patient may also be caused to undress and stand before the medical man at the time when he states that his urine usu- ally passes of. In cases of feigning, the ab- dominal muscles will be seen contracting in order to expel it. 51. Bloody Urine has been simulated by the ingestion of beet-root, madder, the extract of logwood, the fruit of the prickly pear, the In- dian fig, &c. But blood is more frequently mixed with the urine. Percy and Laurent state that conscripts have injected blood into the bladder, in order to imitate hematuria. This disease has even been occasioned by hav- ing recourse to cantharides. A boy in Staf- fordshire, in 1617, having accused a woman of bewitching him, feigned various maladies, and, among others, the excretion of black urine. The wisdom of our ancestors condemned the wom- an to be burned, as was usual in such cases; but the bishop of the diocess, suspecting im- posture, caused the boy to be watched, when he was detected dipping cotton in ink, and af- terward introducing it within the prepuce, in order to give the urine, which he publicly void- ed, its dark colour. {Mem. of Literature, vol. iv., p. 357.) 52. The excretion of Gravel, and of other substances, has likewise been feigned. In all such cases, as well as the foregoing, the per- son should be made to urinate in the presence of the physician. The real existence of gravel is ascertained beyond doubt, by close inspection and chemical analysis.* Strictures have also been feigned ; but the passage of a bougie will always ascertain their reality in the hands of an expert surgeon. Suppression and Retention of Urine have been pretended, but most fre- quently by convicts and hysterical females. The introduction of the catheter, and a strict watch, will generally show the state of the case. 53. Uterine Diseases have been feigned and exaggerated, and I believe more frequently than is commonly supposed. It was attempted in one case, in which I was, some years ago, con- sulted ; but the object becoming apparent, I withdrew. This kind of simulation is some- times adopted with an evident motive, as dis- like of a husband, &c. ; but in other cases the object is not so apparent. Dr. Thomson, of Edinburgh, mentions an instance of a female in a respectable station who pretended to pass vesicular bodies resembling hydatids from the vagina. They were ascertained to be prepared from the intestines of a pig, and were made to resemble a string of beads. 54. Varicose Veins have been caused by ligatures or pressure made in the course of the larger trunks. They may also be aggravated, when already present, in a similar way. At- tentive examination, and the means advised for ulcers ($ 49), will generally detect the de- ception, and prevent it. 55. Wounds have been both pretended and inflicted intentionally. The feigning of wounds has been sometimes practised to avoid the danger of battle, or to be mentioned in de- spatches. Means which may occasion the ap- * [For a remarkable case, in which both urine and gravel were feigned to be secreted and discharged from the mouth, rectum, urethra, nose, ear, side, and umbilicus, see my edi- tion of Guy's Forensic Medicine, p. 25(1.]](https://iiif.wellcomecollection.org/image/b21111017_0035.jp2/full/800%2C/0/default.jpg)
