6054 Freiherr von Münchhausen, the ‘Baron of Lies’ and a paediatric syndrome

Objectives The purpose of this abstract is the examination of the historical person Hieronymus Karl Friedrich Freiherr von Münchhausen and his links with Baron Munchausen, also called the 'Baron of Lies'. Furthermore, the paediatric syndrome associated with Baron Munchausen is discussed. Methods A non-systematic literature review of relevant books, book chapters, journal articles and internet sites in English and German was performed. Emeritus Professor Tim David kindly contributed 9 references from his database. The resulting citations were analysed by the author. Ethics approval and patient consent were not required for this study. Results The term Munchausen syndrome by proxy (MSbP) was coined in 1977 to describe a form a child abuse which has an incidence of 0.1–3 per 100,000. It is characterised by the exaggeration and fabrication of signs and symptoms or the infliction of illness on a child by their carer. During the past decades the nomenclature used to describe this medical condition has changed repeatedly: MSbP, Polle syndrome, Meadow syndrome, fabricated or induced illness (FII), medical child abuse (MCA) and factitious disorder imposed on another (FDIA). Freiherr von Münchhausen was a German cavalry officer who lived in the 18th century in Lower Saxony near Hannover. He was well known for telling fantastic stories about his military adventures at dinner parties. In 1781, these anecdotes were published anonymously in Berlin in the book 'Vademecum für lustige Leute', edited by August Mylius. The writer Rudolph Erich Raspe embellished von Münchhausen's stories and translated them into English, thus creating Baron Munchausen, the 'Baron of Lies'. The poet Gottfried August Bürger translated them back into German. The real Freiherr von Münchhausen was not impressed by these developments and died at the age of 77.¹–⁵ Conclusion Baron Munchausen is a fictional figure loosely based on the German nobleman Freiherr von Münchhausen. Factitious disorder imposed on another is the official diagnosis for a caregiver who inflicts illness on a child. Fabricated or induced illness and Munchausen syndrome by proxy are alternative names which are still widely used. The American term medical child abuse is somewhat confusing as it may imply that the perpetrator of the abuse is a medical professional who intentionally harms a young patient. References Strehle EM. From Munchausen syndrome by proxy to factitious disorder imposed on another: What's in a name? Acta Paediatr 2023 Oct;112(10):2032–2034. Strehle EM. Freiherr von Münchhausen and the two syndromes bearing his name. Arch Dis Child 2023 Aug. doi:10.1136/archdischild-2023-325915. Meadow R, Lennert T. Munchausen by proxy or Polle syndrome: which term is correct? Pediatrics 1984 Oct;74(4):554–556. Roesler TA, Jenny C. Medical Child Abuse: Beyond Munchausen Syndrome by Proxy. Washington DC: American Academy of Pediatrics 2008. Olry R, Haines DE. Historical and literary roots of Münchhausen syndromes: as intriguing as the syndromes themselves. Prog Brain Res 2013;206:123–141.