Two strange cases of functional disorder : with remarks on the association of hysteria and malingering / by F. Parkes Weber.

  • Weber, Frederick Parkes, 1863-1962.
Date:
1912
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Licence: In copyright

Credit: Two strange cases of functional disorder : with remarks on the association of hysteria and malingering / by F. Parkes Weber. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    of the tissues below it. Between the attacks her general health was fair, but she seemed weak. The hemorrhage was not external, but into the subcutaneous tissue. There was never haemoptysis, and blood was never passed from the bowel or kidneys. But once some dark blood was vomited, and Sir A. A. Bowlby tells me that at least on one occasion, when the mammary region was involved, some bloody fluid could be squeezed from the nipple. There was no evidence of any organic visceral disease. Typical attacks at St. Bartholomew’s Hospital were as follows: “ Malaise and headache—followed in one or two days by the appearance of hemorrhagic swellings in the subcu- taneous tissues of various parts of the body. The patient becomes very much collapsed and vomits all food. Supposed hyperpyrexia. The hsematomata gradually become absorbed and her general con- dition improves.” Some of the swellings were aspirated and nothing but blood was drawn off. In December, 1891, a large swelling formed around the left knee; this swelling was incised and blood was let out; it then healed up. Incisions into the skin did not bleed more than in the case of healthy persons. There was no family his- tory of haemophilia or other hemorrhagic tendency. The urine, when examined, was apparently always free from albumin, sugar, and blood. During the latter part of her time at St. Bartholomew’s Hospital the “ attacks ” seemed to have recurred somewhat less fre- quently than at first, but there was no very decided improvement. On October 30, 1893, the patient was transferred from St. Bar- tholomew’s Hospital to a home at Torquay. In the home the pres- ence of some hysterical anaesthesia was noted, and the vomiting and abdominal pain (the pain had been complained of since 1891) were very troublesome. Gradually an improvement took place in regard to the attacks of vomiting and subcutaneous hemorrhages. Then these symptoms ceased altogether. The patient seemed, however, to have developed a tendency to malingering, and on one occasion she was discovered beating the stump of her right arm against some- thing hard, apparently in order to produce an artificial “ hemorrhagic attack ” ; she was likewise suspected of tampering with the thermome- ter so as to simulate fever. [It may be mentioned that “ hyper- pyrexia ” had been noted at St. Bartholomew’s Hospital, where appar- ently she began to “play tricks” with the thermometer, etc.] I saw the patient again in 1905, a long time after the attacks of