It is difficult to assign any sufficient reason for this conduct. Mere indolence seems sometimes to be the chief reason for it, oftener vanity; the sense of importance in finding everything in the household arranged with exclusive reference to itself appears to be the motive for it; and this may sometimes be observed to be very powerful even at an exceedingly early age. In many instances a morbid craving for sympathy is mingled with the love of importance, and both these sentiments are not infrequently exaggerated by the conduct of a foolishly fond mother. Real illness, however, in almost all these cases exists at the commencement, though the child persists in complaining of its old symptoms long after their cause has disappeared.
The great difficulty which the doctor meets with in the management of these cases arises from the incredulity with which his opinion is received. Candour is looked upon as so eminently characteristic of childhood, that deceit seems impossible; the case is thought by the parents to be an obscure one which the doctor does not understand; and therefore it is said, he, with want of straightforwardness and of kindness, throws doubts on the existence of disease, and on the truthfulness of a most loving, most suffering child. The vagaries of a hysterical girl, the fits, the palsy, the half-unconsciousness have all been assumed within my own observation by children from ten to fifteen years old, and I have more than once had to give place to the ignorant and impudent pretender who traded successfully on the feelings of the parents. Sometimes, one knows not why, except that the child has got tired of the part he was playing, the symptoms that had caused so much anxiety suddenly disappear, but even then the habit of mind left behind is anything but healthy. Indeed in all cases of this kind it is much less the state of the body than that of the mind which excites my apprehension. The constant watching its own sensations, the habit of constantly gratifying every wayward wish and temper under the plea of illness, and the constant indulgence which it too often meets with in this from the over-kindness of its parents, exert a most injurious influence on its character, and it grows up a juvenile hypochondriac.