Malingering—faking or exaggerating illness or disability—was a relatively common problem in Civil War hospitals. In addition to the age-old reason of malingering to avoid duty, faking illness or disability was especially common during the Civil War because of the bounties offered to men who enlisted. Some men would enlist, get the bounty money, report for duty, fake a debilitating malady, get discharged, then reenlist somewhere else under a different name for a second bounty and repeat the process. As a result, military surgeons had to be on a constant lookout for malingerers, though separating those who were faking from those who had legitimate problems could be difficult.
One surgeon who gained much experience in identifying malingerers was William Williams Keen. Keen would later go on to become a famous doctor and pioneering neurosurgeon, but at the time of the Civil War, he was just beginning his medical career. After serving on the frontlines as an army surgeon, in 1863 Keen began working at Turner’s Lane Hospital in the wards for soldiers with injuries and diseases of the nervous system. There, Keen reported, “we had perhaps more than our usual proportion of malingerers.” There were enough, in fact, for Keen and two of his colleagues to write an article on malingering for a medical journal.
The faked or exaggerated maladies Keen observed among the hospitalized soldiers included anchylosis (immobility of a joint), blindness, lameness, deafness, diarrhea and dysentery, vomiting, spermatorrhea, pain, insanity, back problems, paralysis, thoracic (heart, lungs, etc.) diseases, muteness, and epilepsy. Often, the malingerers were caught due to their own mistakes and inconsistencies; other times, the surgeons were able to trick or scare them into revealing their lie. For suspected malingerers that were tougher to catch, Keen and his colleagues commonly used ether, as they believed that under anesthesia the soldier wouldn’t be able to keep up his charade.
If the surgeons failed to catch a suspected malingerer who showed no physical signs of a real malady, they sent him back to duty anyway. Keen reasoned, “If he be really a well man, no harm is thus done. If he be suffering from diseases which we have failed to detect, he is pretty sure to find his way into a hospital again.” Malingerers who were caught were usually sent back to duty with a note in their file documenting their attempt to malinger so that it would be harder for them to try it again. Theoretically, the malingers could be court-martialed for their deceit, but according to Keen, this course was rarely followed.
Read Keen’s study on malingering, which goes into much greater detail, here. Or read his reminisces on the subject here. For a modern perspective on malingering, try this article. Or search Fold3 for other information on malingering, on Keen, or on life in Civil War hospitals.