Lectures on topics connected with medical jurisprudence delivered before the medical department of the University of Vermont / by E.J. Phelps, April, 1881 ; reported stenographically by Sumner Gleason and Chas. H. Nichols, and printed for the use of the medical class.

  • Phelps, Edward John, 1822-1900.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on topics connected with medical jurisprudence delivered before the medical department of the University of Vermont / by E.J. Phelps, April, 1881 ; reported stenographically by Sumner Gleason and Chas. H. Nichols, and printed for the use of the medical class. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    cision every symptom that he had, every pain or sensation, and exactly to locate it, and then carefully to write them down, just as stated by the patient, and at the time they were stated. In this way he was enabled at each successive inter- view, to preserve an unmistakable record of precisely what symptoms were from time to time claimed to exist, and to compare them with each other, as well as to preclude any dis- pute about the various statements made in regard to them. Such a course is very likely to detect spurious and inconsis- tent symptoms, and to prevent a party from changing his ground, as the emergency of his case might require. He mentioned one case which he had occasion to examine, where, as the result of an accident, seiious internal injury was claimed. The man complained of a severe pain in his kidneys, and of an affection of those organs consequent upon the hurt he had sustained. On being desired to point out the location of the pain, he placed it in a part of his back a good way from where the kidneys are usually found. On a subsequent visit, he still complained of the pain in those organs, and on being again requested to indicate the place, located it correctly; very naively remarking, ■' I have found out where the kidneys are situated, since you were here before. Another very useful means of detection in these, as indeed, in all other cases of feigned disease or injury, is to watch the subject carefully, when he is not aware that he is seen. Few deceptions are so elaborately and perfectly carried out, as to be kept up while the patient is alone, and not exposed to ob- servation, though even such instances have been known. Paralysis, lameness and deformity will often disappear when the mask is thrown off, which it might be very difficult to de- tect when the mask is on. Just as the manifestations of a fic- titious insanity will subside, when there is no further occasion for their display. But after all, as I have said before, the business of detective medicine, its means, its tests, its expedients, belong to medical