Intended for healthcare professionals

Views & Reviews Between the Lines

Suspicious circumstances

BMJ 2011; 343 doi: (Published 07 November 2011) Cite this as: BMJ 2011;343:d7149
  1. Theodore Dalrymple, writer and retired doctor

Sixteen years before Karl Jaspers described primary delusions in his textbook, General Psychopathology, first published in 1913, the writer and doctor Anton Chekhov (1860-1904) gave an account of such a delusion in “Ward No 6.” In this story, a provincial doctor, Andrei Yefimitch Ragin, is himself ultimately admitted to the ward for lunatics whom he has long neglected and whose suffering he has equally long ignored.

One of the patients in ward 6 is Ivan Dmitritch Gromov. The Gromov family fortunes had begun to decline when his brother died of consumption; his father, an official, is then arrested for misappropriation of funds and dies of typhoid in the prison hospital. Young Ivan …

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