Malingering has become much more common since the National Health Insurance Act has been passed. The possibility of obtaining a fair sum each week without the necessity of working for it induces many persons either to feign disease or to make recovery from actual disease or accident much more tedious than it ought really to be.
The feasibility of successfully malingering is greatly enhanced by the possession of some chronic organic disease. An old mitral regurgitant murmur is useful for this purpose.
It is not flattering to one's vanity to overlook a case of malingering, but should this occur little harm is done. It is a much more serious matter to accuse a person of malingering when in reality he may be suffering from an organic disease.
Here are some of the diseases which are most frequently feigned:
=Nervous Diseases=, as headache, vertigo, paralysis of limbs, vomiting, sciatica, or incontinence or suppression of urine, spitting of blood; others, again, simulate hysteria, epilepsy, or insanity.
On the other hand, the malingerer may actually produce injuries on his person either to excite commiseration or to escape from work. Thus, the beggar produces ulcers on his legs by binding a penny-piece tightly on for some days; the hospital patient, in order to escape discharge, produces factitious skin diseases by the application of irritants or caustics.
It is much more difficult to decide whether certain symptoms are due to a real disease which is present, or whether they are merely exaggerations of slight symptoms or simulations of past ones. The miner, after an injury to his back, recovers very slowly, if at all. He is suffering from 'traumatic neurasthenia'--a condition only too often simulated, and a disease very difficult to diagnose accurately. The miner takes advantage of our ignorance, and continues to draw his compensation. A workman during his work receives a fracture; instead of being able to resume work in six weeks, he asserts that the pain and stiffness prevent him, and this disability may persist for months. Such cases as these frequently come before the courts when the employer has discontinued to pay the weekly compensation for the injury. Medical men are called to give evidence for or against the injured workman.