|
In 1794, at the age of 74,
Munchausen's married Bernhardine Brun, then 17 years old. It is
said that on their wedding night, the baron retired early, and
his bride spent the night dancing with another. In 1795,
Bernhardine gave birth to a son. Following the birth of this
child, it was whispered that "the life of the Munchausen
child will likely be short." The boy, named Polle, died at
approximately 1 year of age under suspicious circumstances.
Almost a century later, an
unusual behavior pattern among young men gained recognition in
the writings of Charcot. In 1877, he described adults, who
through self-inflicted injuries or bogus medical documents,
attempted to gain hospitalization and treatment. Charcot called
this condition "mania operativa passiva."
Seventy-four years later, in
1951, Richard Asher described a similar pattern of self-abuse, where
individuals fabricated histories of illness. These fabrications
invariably led to complex medical investigations,
hospitalizations, and at times, needless surgery. Remembering
Baron von Munchausen's and his apocryphal tales, Asher named this
condition Munchausen's Syndrome.
Today, Munchausen's Syndrome is
a recognized psychiatric disorder. The American Psychiatric
Association's Diagnostic and Statistical Manual of Disorders
(DSM III-R) describes it as the "intentional production of
physical symptoms."
(Note: In contrast to its adult namesake, the
American Psychiatric Association's DSM III-R does not consider
Munchausen Syndrome by Proxy a psychiatric disorder.)
MUNCHAUSEN'S
SYNDROME BY PROXY
The term "Munchausen's
Syndrome by Proxy" (MSBP) was coined in a 1976 report
describing four children who were so severely abused they were
dwarfed. In 1977, Roy Meadow described a somewhat less extreme
form of child abuse in which mothers deliberately induced or
falsely reported illnesses in their children. He also referred
to this behavior as MSBP.
Over the years, alternate
terms, such as "Polle's syndrome" and "Meadow's
syndrome," have been suggested; however, these terms never
gained popularity.
Tragically, MSBP victims are
usually children, and the perpetrators are almost always parents
or parent substitutes. If and when victims are hospitalized,
they may be subjected to multiple, and at times, dangerous
diagnostic procedures that invariably produce negative or
confounding results. When the victim and abuser are separated,
however, the victim's symptoms cease. When confronted, the
abuser characteristically denies any knowledge of how the
child's illness occurred. |