Chromidrosis of the
lower eyelids in young women often owes its origin to a box of paints.
Factitious skin diseases are seen most commonly on the face and
extremities, especially on the left side--in other words, on the most
accessible parts of the body.
Feigned menstruation, pregnancy, abortion, and recent delivery are
common, and should give rise to no difficulty. The same may be said of
feigned insanity, aphonia, deaf-mutism, and loss of memory.
The following hints may be useful to a medical man when called to a
supposed case of malingering: Do not be satisfied with one visit, but go
again and unexpectedly; see that the patient is watched between the
visits; make an objective examination, compare the indications with the
statements of the patient, noting especially any discrepancies between
his account of his symptoms and the real symptoms of disease; ask
questions the reverse of the patient's statements, or take them for
granted, and he will often be found to contradict himself; have all
dressings and bandages removed; suggest, in the hearing of the patient,
some heroic methods of treatment--the actual cautery, or severe surgical
operation, for example; finally, chloroform will be found of great use
in the detection of many sham diseases.
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