The simulators: truth and power in the psychiatry of José Ingenieros. / Los simuladores: verdad y poder en la psiquiatría de José Ingenieros.

Using Michel Foucault's lectures on "Psychiatric power" as its starting point, this article analyzes the book Simulación de la locura (The simulation of madness), published in 1903 by the Argentine psychiatrist José Ingenieros. Foucault argues that the problem of simulation permeates the entire history of modern psychiatry. After initial analysis of José Ingenieros's references to the question of simulation in the struggle for existence, the issue of simulation in pathological states in general is examined, and lastly the simulation of madness and the problem of degeneration. Ingenieros participates in the epistemological and political struggle that took place between experts-psychiatrists and simulators over the question of truth.

Los simuladores: verdad y poder en la psiquiatría de José Ingenieros / The simulators: truth and power in the psychiatry of José Ingenieros

Resumen Tomando como punto de partida el curso de Michel Foucault “El poder psiquiátrico”, se analiza el libro Simulación de la locura, publicado en 1903 por el psiquiatra argentino José Ingenieros. Foucault afirma que el problema de la simulación recorre transversalmente toda la historia de la psiquiatría moderna. Inicialmente se analizan las referencias que José Ingenieros dedica a la cuestión de la simulación en la lucha por la vida, para luego abordar la temática de la simulación en los estados patológicos en general y, por fin, la simulación de la locura y la problemática de la degeneración. Ingenieros participa de esa lucha epistemológica y política que se establece entre peritos-psiquiatras y simuladores en torno a la cuestión de la verdad.

Abstract Using Michel Foucault’s lectures on “Psychiatric power” as its starting point, this article analyzes the book Simulación de la locura (The simulation of madness), published in 1903 by the Argentine psychiatrist José Ingenieros. Foucault argues that the problem of simulation permeates the entire history of modern psychiatry. After initial analysis of José Ingenieros’s references to the question of simulation in the struggle for existence, the issue of simulation in pathological states in general is examined, and lastly the simulation of madness and the problem of degeneration. Ingenieros participates in the epistemological and political struggle that took place between experts-psychiatrists and simulators over the question of truth.

Pseudodementia, a term for its time: the impact of Leslie Kiloh's 1961 paper.

OBJECTIVE: It is 50 years since Leslie Kiloh's paper titled "Pseudo-dementia" was published. The present article aims not only to honour the work and achievements of Professor Kiloh, but also to consider the impact and importance of that 1961 paper. CONCLUSIONS: Kiloh presented vignettes concerning 10 patients, most of whom presented with depressive features. The term "pseudodementia" had been used previously. However, Kiloh's paper gave impetus to psychiatrists to focus on the potential reversibility of cognitive impairments that might be attributable to psychiatric disorders (depression, schizophrenia and conversion disorder among them). The historical context of the paper needs to be highlighted; it was written at a time when dementia was defined as being irreversible. Outcome studies and ongoing research have shown that cognitive deficits in cases of depression commonly cannot be fully reversed, and commonly herald emergence of an underlying progressive dementing disorder. Nevertheless, it is argued that the term has remained useful in fostering discussion of potentially treatable psychiatric symptoms, even in cases of progressive dementia.

Lasthénie de Ferjol syndrome: a rare disease with fascinating history.

In our paper, we present the fascinating story of Lasthénie de Ferjol syndrome. A rare self-induced iron deficiency anaemia caused by surreptitious blood-letting. The French haematologist Jean Bernard first described the syndrome and named it after the heroine of Barbey d' Aurevilly's novel The Story without a Name. This factitious anaemia presents a great challenge for physicians even today, both in diagnosis and in therapy.

The origins of factitious disorder.

Factitious disorder is the deliberate simulation of illness for the purpose of seeking the sick role. It is a 20th-century diagnosis, though the grounds for its introduction are uncertain. While previous authors have considered the social changes contributing to growth in the disorder, this article looks at some of the pressures on doctors that may have created the diagnostic need for a disorder between hysteria and malingering. The recent history of those disorders suggests that malingering would no longer be acceptable when applied to the potentially larger numbers involved in workers' compensation or in mass conscription. Equally, the absolution given to hysteria on the basis of the Freudian subconscious would survive only as long as that model retained credibility. Growing egalitarianism and changing doctor-patient relationships in the 20th century would no longer tolerate a sharp division between culpable malingering and exculpated hysteria, which may previously have been made on grounds of class or gender. They would contribute to the need for a mediating diagnosis, such as factitious disorder.

Feigned and factitious diseases in the British Forces c.1830-1840: a forgotton medical classic.

Soldiers and seamen were remarkably inventive in their methods of feigning disease; I know of few cases where soldiers today have gone to such determined efforts to simulate a disease. All of us have encountered malingerers in the course of our work but the extent and array to which they extend in their attempts is greatly surpassed by the tales of effort and guile reported by Gavin. Fit, content men have always been at the centre of the military capability and in the forces of the present day the driving concerns to discharge oneself from the army or navy are no longer quite as pressing. However, medical officers should always be alert to the art of feigning. I will leave the last word to Hector Gavin: "As long as soldiers have the idea that they can impose upon officers, and that the result will be for their advantage, so long will examples of imposition occur in the army. "

Single case experimentation: a seventeenth century example.

This paper describes a seventeenth century case which contains most of the features of a modern single case experiment. The method employed was similar to the forced choice technique now used to detect 'hysterical' sensory symptoms.

[The Ganser syndrome and its ups and downs]. / Le syndrome de Ganser et ses avatars.

Ganser, in 1897, described a syndrome that the main symptoms were: Impaired consciousness, distorted communication (Maladjusted answers, looking like dementia nonsense). This syndrome was first included to hysteria. Gradually, the most striking aspect, approximate answers, has been stretch as regards to his pathogeny, to other concepts like post-traumatic disease, depression and especially schizophrenia. In this way, the Ganser's syndrome now cover a large scale of troubles related to perturbation of communication and with non psychopathologic relation to the primitive syndrome.