[1] Tics and their treatment. English translation by S. A. K. Wilson. New
York, 1907. This book contains an extended bibliography.
VIEWS OF THE FRENCH SCHOOL
The usual conception of tics, as laid down by Brissaud, Meige and
Feindel,[1] may be stated as follows: Tic movements are physiological acts
which were originally functional and purposeful in character, but which have
become habits, apparently purposeless and meaningless. The motor reaction is
the result of some external stimulus or idea (normal or abnormal) or both,
which originally was necessary for the production of the tic movement, which
latter eventually became habitual and automatic, and, owing to repetition,
was executed, even in the absence of the external stimulus or idea, without
apparent purpose or meaning. At first but little more than purposive habit
movements, they finally became irrepressible acts which sought for
expression, which were but little under the control of the will, which
occurred in attacks varying in frequency, duration and severity, which
decreased under distraction and generally ceased during sleep, which were
increased in frequency and duration and severity by fatigue, emotional
upset, mental unrest, conflict and strain, while the lack of inhibition and
will power, the lack of self-control was the dominant mental state, leading
to feelings of insufficiency, doubt, indecision and incapacity, and making
the ground work for the psychasthenic reactions in the form of morbid
impulses and obsessions, and for the hysterical, so-called neurasthenic and
other morbid psychic trends.
The inherent or acquired neuropathic and psychopathic state is the basic
condition which prepares the subsoil.
From a consideration of the motor symptom we may say that it is but a
pathological habit, which, however, is apt to lead to the tendency toward or
generation of an increasing number of such pathological habits.
Characteristic of tics we may mention their being conscious before and after
but not during their execution, their being disordered functional acts,
their impetuous, irresistible demand for execution, the antecedent desire,
and the subsequent satisfaction.
The etiology of tics, as laid down by Meige and Feindel, may be summed up by
stating that they occur most frequently in young subjects, less frequently
in savages and animals than in the civilized, there is a psychic
predisposition based on heredity (of a similar or dissimilar neuropathy or
psychopathy) upon which Charcot laid great stress, imitation (especially in
the young) plays a role, as also brain fatigue (emotion, mental upset and
worry) and indolence, with the frequent exciting cause of an external or
internal stimulus or an idea, which is the explanation of the origin,
source, situation and form of the tic or tics present in any particular
case.
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