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