From Big Medical Encyclopedia

ARTIFICIAL DISEASES — intentional reproduction of a disease or its separate symptoms with infliction of harm to the health. And. are caused mechanical, chemical, thermal or otherwise for the purpose of evasion from obligations of military or civil service, obtaining any benefit, privileges, etc. In the practical relation artificially reproduced damages of skin and hypodermic cellulose have the greatest value: dermatitis, ulcers, strupa, abscesses, phlegmons, hypostases, swellings, tumors, hems, hypodermic emphysema, fistulas, etc. And. other bodies and systems meet less often.

Artificial dermatitis is caused by rubbing in or applying to skin of the irritating substances — kerosene, gasoline, caustic alkalis causing an inflammation of skin, a cut reminds ro zhisty. The lyutikovy dermatitis reminding a thermal burn is caused by juice of a creeping caustic buttercup. At suspicion of lyutikovy dermatitis it is recommended to examine carefully the surface of defeat since in some cases it is possible to find the parts of a plant confirming an artificial origin of dermatitis. The formed bubble, unlike burn, is filled with whitish student invisible contents. At simultaneous appearance of a group of persons with such damages of skin the diagnosis of lyutikovy dermatitis is simple.

Artificial phlegmons and abscesses develop at introduction under skin of kerosene, gasoline, turpentine and other chemical substances, and also foreign bodys (threads, paper, fabrics) and the infected materials. One of the characteristic signs testimonial of the artificial nature of phlegmon — existence on skin of traces from a prick a sharp object. The wound from a prick can be covered with a crust, from it bloody or purulent liquid is sometimes emitted; in some cases it turns into fistula. Chemical and bacterial, a research of contents of phlegmon allows to establish true character it.

Artificial hypostases can be caused by pulling of an extremity a cord, bandage, an elastic band, etc. or long systematic traumatization of the site of an extremity. Usual localization of artificial hypostasis — a dorsum of a brush, a thicket left, a dorsum of foot and a front surface of a shin. Edematous fabrics in the subsequent become dense. At survey traces of a banner and sharp border of hypostasis between the changed and intact fabrics can be found. At the hypostases caused by effleurage signs of hemorrhages are found.

Artificial tumors arise at introduction under skin of substances almost insoluble and indifferent in character — vaseline, vegetable and machine oils, paraffin, etc. Such «tumors» very slowly resolve and can simulate various diseases (tuberculosis, an actinomycosis, benign and malignant tumors); are localized preferential on the left half of a body i.e. where administration of substance perhaps investigated. For the purpose of diagnosis the puncture of a tumor, a biopsy can be applied. Gistol, the research confirmed court. - a chemical research, allows to establish an artificial origin of a tumor and character of the entered substance.

Artificial formation of hems is reached by cuts of skin in the places typical for some operations (e.g., for appendectomy, a laparotomy). These hems can be given for postoperative. In such hems in some cases suppuration volunteers and supported. Hems «after burns», «after operations», etc. can be exposed to a secondary inflammation or an ulceration owing to irritation friction, bruises, greasing by the irritating substances that interferes with healing.

Artificial hypodermic emphysema is caused by introduction through punctures under skin or mucous membranes of air owing to what there is a limited or widespread swelling, most often on a face; quite often complications in connection with penetration of an infection join. Artificial emphysema can simulate an erysipelatous inflammation. Crepitation under skin at palpation and dot wounds in places of punctures allow to make the correct diagnosis.

Artificial ulcers arise during the drawing on skin of the caustic irritating substances (sulfuric, salt and acetic to - t, corrosive sublimate, a vitriol, etc.), during the applying of hot objects, wet wood ash. The unusual form of an ulcer — quadrangular, correctly oval, etc. — indicates its artificial origin.

Artificial diseases of joints reproduce introduction to a joint or the fabrics of the irritating liquids surrounding it (gasoline, kerosene, turpentine, etc.), combining it in some cases with long bandaging; sometimes at the caused inflammation of a joint fistulas can be formed. At diagnosis diseases at which joints usually are surprised are excluded. In fresh cases the puncture of a joint with the subsequent chemical research of punctate is recommended. On skin in a joint sometimes find hems from injections and ulcers.

Acute mental disorders are caused most often by reception of high doses of medicinal substances (e.g., drug «Asthmatolum») or the herbs containing atropine. At symptoms of acute poisoning in these cases in allocations of the patient (urine, rinsing waters, emetic masses) atropine can be found.

Artificial diseases warmly - vascular system. Most often artificially cause a hypertension by means of the use of ephedrine or complex medicines containing ephedrine. At the same time there can be permanent painful frustration with development of an idiopathic hypertensia with high figures of the ABP — 160 — 180/110 — 120 mm of mercury. Careful and numerous measurement of the ABP and pulse which sharp fluctuations are characteristic at the use of ephedrine, court. - a chemical research of urine, in a cut crystals of ephedrine can be found, help diagnosis.

Artificial diseases of a respiratory organs meet seldom. Have practical value And. lungs, caused by long inhalation of icing sugar. At the same time in lungs there are changes, radiological similar to a picture of miliary tuberculosis.

Artificial diseases of digestive tract — gastritises and stomach ulcers develop at introduction to a stomach of various pyretics, and also at a bruise of a mucous membrane of a stomach. Diagnosis of an artificial origin of such defeats is possible in cases of detection of chemical burns of face skin, mucous membrane of a mouth and gullet, and also at detection to - the t which are not a part of a gastric juice. Colitis which usually gives out for dysentery are caused by reception of high doses of laxative substances or soap pills. Careful overseeing by the patient, court. - a chemical research of excrements allow to establish the artificial nature of a disease.

Artificial prolapses of the rectum arise at introduction to a rectum of a foreign body at several o'clock or days, than the dense obkhvatyvaniye is provided with walls of a gut of the entered subject; quickly and with effort the taken subject twists a mucous membrane of a rectum. Loss seldom happens resistant.

Artificial diseases of urinogenital system — cystitis and uretrita are caused by administration of the irritating substances or foreign bodys, and also air in a bladder and an urethra. The artificial ulcers in the field of generative organs caused by various substances and given for venereal diseases are known. Wedge., bacterial, and chemical researches allow to establish the true nature of a disease.

Artificial diseases of an organ of sight take place at use of mechanical or chemical irritants. In a conjunctival sac it is possible to find small foreign bodys, the remains of the irritating substances, etc. At diagnosis existence of limited necroses from the caustic cauterizing substances on a conjunctiva of a century is also considered. The research of eye separated allows to reveal the applied substance sometimes.

Artificial diseases of a nose for the purpose of receiving bleeding can be caused by injury of a mucous membrane of a nose by any subject, a prick by a needle, a nail. Diagnosis of such damages is based on careful survey of nasal cavities; it is necessary to exclude the diseases which are followed by frequent nasal bleedings.

And. can be a subject court. - medical examinations when their existence is the basis for criminal prosecution. Expertize is carried out under the resolution of judicial investigating authorities. The examinee at the same time shall be put in the conditions depriving of it an opportunity to support a state And. Expertize is carried out, as a rule, in a hospital; in the commission on examination the doctors-clinical physicians competent of diagnosis of the suspect I surely are attracted. Conclusion court. - the medical expert the wedge, inspection using laboratory, etc. methods of a research is based on comprehensive.

See also Simulation , Mutilation .

Bibliography: Avdeev M. I. Forensic medical examination of living persons, page 175, M., 1968; Nadezhdin V. A. Artificial and feigned diseases, L., 1927, bibliogr.; Chistyakov N. L. About surgical artificial diseases and about mutilation among prisoners, New hir., t. 9, No. 6, page 56, 1929, bibliogr.

V. V. Tomilin.