Thus we see that malingering has its _raison d'être_; that, after all,
it is not at all strange that the suspicion of its existence should be
so frequently raised by our legal brethren--yes, and medical brethren,
too; that in reality it ought to be a very common manifestation.
Nevertheless, paradoxical though it may seem, cases of pure malingering
of mental disease are comparatively rare in actual practice.
Wilmanns,[5] in a report of 277 cases of mental disease in
prisoners, cites only two cases of pure malingering, and in a later
revision of the diagnoses of the same series of cases the two cases of
malingering do not appear at all. Bonhoeffer,[6] in a study of 221
cases, found only 0.5 per cent of malingering. Knecht,[7] in an
experience of seven and a half years at the Waldheim Prison, did not
observe a single case of true malingering. Vingtrinier[8] claims not to
have found a single case of true malingering among the 43,000
delinquents observed by him during his experience at Rouen. Connolly,
Ball, Krafft-Ebing, Jessen, Siemens, Mittenzweig, and Scheule are quoted
by Penta as having expressed themselves that pure malingering is
extremely rare. Penta, on the contrary, observed about 120 cases during
his four years' service in the prison in Naples. He gives as the reason
for this unusually high percentage of cases observed by him the fact
that two-thirds of the inmates of the prison belonged to the Camorra, an
organization whose members are gleaned from the lowest and most
degenerate stratum of society, and in whom the tendency for deception
and fraud in any form is highly developed.
The question naturally arises, What is the reason for this rarity of
cases of malingering? Is it because man has reached a state of
civilization where he no longer resorts to deception? Decidedly not. The
reason lies almost wholly in our changed attitude of today towards this
question. As we acquire more real insight into the workings of the human
mind we are prone to become more tolerant towards the human weaknesses,
and in our study of the malingerer it is the type of individual, his
mental make-up, which interests us most, rather than the malingered
symptoms. It is for this reason that today the number of authorities is
indeed small who do not look upon malingering _per se_ as a morbid
phenomenon, as an abortive attempt at adjustment by an individual who is
quite incapable of adequately coping with the vicissitudes of life. In
my own limited experience of several years with insane delinquents I
have yet to see the malingerer who, aside from being a malingerer, was
not quite worthless mentally.
Public-domain text, read in full here on John Shaqi.
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