d on June 14, 1911.

There can be no doubt that this man malingered mental symptoms, neither
need there be the slightest doubt about his having suffered from an
actual mental disorder. The motive for his malingering is perfectly
obvious. Finding himself suddenly confronted with a charge of
infanticide, and rent by the various conflicting emotions which a
realization of this carries with it, he resorted to the common weapon of
defense, malingering of mental symptoms. We have seen that he deceived
no one but himself; that in reality he was a very seriously affected
individual. It was fortunate for him that because of some lucky turn of
events he landed in a hospital instead of in jail.

A more or less similar case recently received the maximum sentence of
life imprisonment for manslaughter. In this instance the case was
chiefly observed by jail officials instead of physicians in its early
course.

The foregoing case, it seems to me, illustrates very well that, while we
are fully justified in assuming a relationship of cause and effect in
many cases of malingering, in many others malingering and actual mental
disease are concomitant phenomena, having a common root in the same
diseased soil. Thus Pelman[10] holds simulation in the mentally normal
to be extremely rare, and he always finds himself at a loss to
differentiate between that which is simulated and that which represents
the actual traits of the individual. My own experience prompts me to
agree with Pelman. This confusion and difficulty of differentiation
between actual mental disease and malingered symptoms may manifest
itself in two ways. The same individual may be suffering at one time
from a frank mental disorder, and at some later period, finding himself
in a stressful situation, malinger a psychotic state, or, as we saw in
the preceding case, malingering of symptoms may manifest itself during
the course of a frank mental disorder, as will be further illustrated in
succeeding cases. Pelman's statement, however, applies most forcibly to
that mass of border-line cases which will be discussed later.

T. W. was admitted to the Government Hospital for the Insane from the
United States Penitentiary, Leavenworth, Kan., on June 16, 1910, at
the age of twenty-nine. He was serving at the time a sentence of eight
years for post-office robbery. His own version of his family and past
personal history is unreliable. He claimed to have suffered from a
paralysi