WHEN A patient presents himself to a physician, the latter directs his attention to an understanding of the patient as a physiological and psychological entity. Tests, laboratory procedures, and studies of functions are part of an investigation, each being interpreted in terms of the whole patient. A blood cell count, audiogram, or electrocardiogram is no more a portrait of a person than is an x-ray film of the skull. These physical measurements are fragments, each piece contributing its share to the total picture. A discussion of tests utilized in identifying so-called simulated deafness should be considered not as isolated observations but within the context of the whole patient.
Hearing ultimately is a psychological experience. Certain physical environmental changes act as stimuli which alter the minute-by-minute status of the organic physiological receptor acoustic apparatus. The stimulus must be of such dimensions that changes will occur in the receptors. This receptor system
HELLER MF, LINDENBERG P. EVALUATION OF DEAFNESS OF NONORGANIC ORIGIN. AMA Arch Otolaryngol. 1953;58(5):575–581. doi:10.1001/archotol.1953.00710040601005
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