Syndrome, Munchhausen

Recurrent feigning of catastrophic illnesses. Munchhausen syndrome is a psychological disorder that is characterized by the recurrent presentation of the patient for treatment of an acute and often dire illness that is, in reality, not present.

The person with Munchhausen syndrome usually gives a plausible and dramatic history. All of it is entirely false. The patient tends to go from hospital to hospital feigning medical or surgical diseases and giving false and fanciful information about their medical and social background. They may even have unnecessary surgery repeatedly, resulting for example in a “mass of scars” on the abdomen, what has been called a “gridiron abdomen.” Some patients with Munchhausen’s syndrome cause their own illness, as by secretly ingesting or injecting substances.

The syndrome was named by an astute English physician Richard Asher in 1951 after the German cavalry officer Baron Karl Friedrich Hieronymous von Munchhausen (1720-97), a teller of tall tales.

Although Asher named the syndrome, he did not discover it. In 1893 Henry Miege, a student of the famed French neurologist Jean Charcot, wrote his thesis on patients with the syndrome and Charcot (1825-1893) referred to it in his own writing. Forty years later, the Kansas psychiatrist Karl Menninger (1893-1990) discussed the subject in a paper entitled “Polysurgery and Polysurgical Addiction.”

However, it was Asher’s article that crystallized the syndrome and brought it to general medical attention. The first sentence in Asher’s article stated, “Here is described a common syndrome which most doctors have seen, but about which little has been written.” This prompted a flurry of responses in which doctors testified that they, too, had had patients with this mysterious malady.

Although the Baron’s name was Munchhausen, it is commonly written without the umlaut as “Munchhausen” in English.