with it, becomes melancholy, suspicious, and mildly
delusional. There is, however, considerable doubt in my mind as to the
genuineness of these symptoms; unquestionably genuine is only the
psychopathic make-up of this individual, which under stress permitted
the development in one instance of a grave psychosis, in another of
malingering.

Cases like the foregoing are by no means exceptions in criminal
departments of hospitals for the insane. It is on account of this type
of prison population that penal institutions furnish us with ten times
as many insane as free communities.

Whatever convictions I possess concerning the subject of malingering
were gained from a fairly extensive experience with insane delinquents
at the Government Hospital for the Insane, and when I assert that I have
yet to see a malingerer who, aside from being a malingerer, was likewise
normal mentally, I do so with the full consciousness that my experience
has been a more or less one-sided one. I mean to say that the material
observed by me came to my notice within the confines of a hospital for
the insane, and that my failure, therefore, to see the so-called pure
malingerer is probably due to this circumstance. I shall not argue this
point further, but merely state that it is true I have not had
experience with the detected and convicted malingerer in the jail and
court-room. I have had ample opportunity to study this same genus later
as a patient in the hospital.

It would be an extremely interesting study to follow up the later
careers of the so-called detected malingerers who are sent to prison and
see how many of them later find their way to hospitals for the insane. A
setting forth of these figures--and I doubt not for one second that the
number is not at all inconsiderable--would not in the least have to be
construed as a criticism of the diagnostic acumen of the original
investigator. It would simply substantiate the truth of our contention
that in the malingerer we see a type of individual who is far from
normal, and in whom malingering as well as frank mental disease is not
at all a rare phenomenon.

I have no doubt whatever that a considerable number of suspected
malingerers are annually sent to penal institutions, there to be later
recognized in their true light and transferred to hospitals for the
insane; else it would be difficult to account for the fact that mental
disease, according to many authors, is at least ten times as fre