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Full text of "Medical Jurisprudence And Toxicology"

382                                                MEDICAL JURISPRUDENCE

FEIGNED INSANITY

There is always some motive for feigning insanity. For instance, a
criminal pretends insanity to escape sentence of death or a prolonged term
of imprisonment for a very grave offence, such as murder, especially when
he is placed on trial. In civil practice an individual feigns insanity to try
and avoid the results of business transactions or deeds, which he may have
executed. Policemen, soldiers and sailors do so, when they wish to leave
the service and are not allowed to do so, or when they know that they are
likely to be punished very severely for some gross neglect of duty.

The detection of feigned insanity is one of the responsible duties of a
medical officer. Ordinarily, it is easy to detect the fraud, but at times it
becomes very difficult, when the individual should be detained under
observation, before a definite opinion is given. It should be remembered
that such a person cannot be kept under observation for more than ten days
in the first instance, but with the permission of the Magistrate, he may be
detained for further periods of ten days upto a maximum of thirty days.11
During this period the medical officer has to watch him and make a careful
note of all the symptoms exhibited by him, and has also to visit him daily
at unexpected hours without the knowledge of the patient.

The following are the distinguishing features between feigned and true
insanity : 

1.   Feigned insanity always comes on suddenly, and not without some
motive.   True insanity may rarely develop all of a sudden, but in that case
some predisposing or exciting cause will be evident, if a careful history of
the case is taken.

2.    In feigned insanity there is no peculiarity in the facial expression,
which is generally observed in the full developed forms of insanity.

3.    In feigned insanity the individual tries to pass off as insane by
putting forward incoherent maniacal symptoms, especially when he knows
that he is under observation.   There is a total remission of all the symptoms,
when he thinks that he is alone and unobserved.

4.    In feigned insanity the symptoms are not uniform, indicating any
particular type of insanity.   Malmgerers usually mix up the symptoms of
one or two distinct types of insanity.   Such a condition may, however, exist
in true insanity.

5.   In feigned insanity violent exertion occasioned by imitating maniacal
frenzy (which is generally imitated by impostors) will bring on exhaustion,
perspiration and sleep, but a really insane person can stand such exertion
for many days without sleep and fatigue.

6.    A malingerer is not, as a rule, dirty and filthy in his habits.   He may
smear his room with faeces and other filth, if he has seen a true lunatic
doing so.   He will, however, keep a clean space for sleeping and will spare
his person.

7.   The dry, harsh skin, and lips, the furred tongue, constipation, want
of appetite and insomnia are very  often physical manifestations of true
insanity.   These are, as a rule, absent in feigned insanity, as they cannot
possibly be imitated by a malingerer.

RESTRAINT  OF THE INSANE

If an insane person is dangerous to himself or to others, or if he is likely
to injure or squander his property or that of others, he can be lawfully kept

11.   Sec. IB.   Act IV, 1912  (The Indum Lunacy Act, 1912, as modified upto the 1st '
October 1931).         ,                                                                  ,,,',