One day in June, 1900, J. experienced a feeling of discomfort in
the articulation of the lower jaw--the sequel, as a matter of fact,
to a slight alveolo-dental periostitis in the neighbourhood of a
bad tooth--and, interpreting the sensation as a new and grave
symptom in the march of his malady, forthwith proceeded to
investigate its development by playing with his maxilla. Then
ensued a perfect debauch of masticatory movements, in which
agreeable repetition of every conceivable grimace was joined to
protrusion and retraction of the jaw in the search after articular
cracks. He became so wholly preoccupied with this tic of
mastication that ere long he had begun to pinch the mucous membrane
on the inside of the right cheek between the hindmost molars, and
this fresh object of absorbing attention in its turn led quickly to
some excoriation of the mucosa on both sides. No halt was called by
the lower jaw to give the abrasions time for repair, with the
natural outcome that they suppurated and paved the way for an
attack of infective stomatitis with pain, fever, and malaise, which
necessitated the application of the thermo-cautery to the ulcerated
areas for its relief.
The explanation given by the patient of the evolution of the
process was controlled by interrogation of the parents, and no
doubt was left as to its genuineness. In the attempt to dispel the
articular discomfort, he had accidentally bitten himself, but the
consequent pain did not deter him from repeating and continuing the
act until its execution was irresistible.
In these and similar cases, the infelicitous rehearsal of the movements
of mastication is practically always associated with an imperative
desire to experience a sensation at the place actually bitten.
_Cheilophagic_ children, who bite their lips unceasingly, usually
commence by nibbling at some half-separated fragment of epithelium on
the edge of a labial fissure, with the inevitable result that the
erosion is enlarged and fresh particles of the mucous membrane are
detached. Youthful candidates for tics can scarce escape from the
vicious circle. A juvenile patient of ours, F., was in the habit of
gnawing so vehemently at the most insignificant little irregularity of
the mucosa that his lips were constantly chapped and bleeding, and as
they were no less constantly being moistened by saliva, a succession of
new cracks made their appearance, to be promptly torn apart by the
teeth. Local applications of nauseous substances are not always
sufficient to discourage these young "cheilophagics."
It is still more frequent to meet with _onychophagia_, a condition
rightly held to be a stigma of degeneration, and acknowledging the same
pathogenic mechanism as all biting tics.
Public-domain text, read in full here on John Shaqi.
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