Scratching movements are infinite in their variety, and since the
co-operating muscles vary in each case, the question of muscular
localisation is of secondary interest.
The object in view in the act of scratching is relief from some such
source of cutaneous irritation as a pimple, an abrasion, a burn, the
bite of an insect, etc., and so long as the cause persists, the function
is being rationally exercised; but to persevere mechanically,
involuntarily, immoderately, in the absence of pruritus or of other
paræsthesiæ, is a sign that the functional act is growing into a tic.
Innumerable tics are thus developed, and they are intimately associated
with biting tics.
S. passes his hand every instant over his forehead, O. over his eyes, T.
over her lips, P. over his moustache, young J. over his budding
whiskers, etc., etc. These elementary tics are scarcely more than
stereotyped acts, and may maintain the semblance indefinitely, though
there is also the likelihood of their becoming immeasurably more
pronounced.
M. scratches his lips with his nails till they are bleeding; E. suffers
from a facial tic, and scrapes at his forehead and temples to such an
extent that his complexion is perpetually blooming with a crop of little
bleeding excoriations; in some places, as a result of ceaseless rubbing
and tapping, the skin is thickened and discoloured--a condition that
might be known as "scratchers' corns." Madame W. used to tear at her toe
nails with her fingers whenever she had retired for the night; and at
the present time, as a result of incessantly passing a fine gold chain
between the pulp of her fingers and the nails, she has succeeded in half
detaching the latter from their bed.
A case reported by Raymond and Janet[100] is one of unusual severity.
A little girl ten years old was covered from head to foot with
scabs and sores, some of which on the body were several centimetres
in diameter and looked very ugly. These she had contrived to
inflict on herself, in spite of every precaution and admonition. It
appeared that successive attacks of measles and of whooping-cough
at the age of five had entailed long rest in bed, and had been
followed by a tardy convalescence, in the course of which the
development of a few pimples on the forehead was the signal for her
to commence scratching them and any other part of her body where
there was the least discomfort, or where the skin was at all
roughened. This merciless self-mutilation ended in the production
of large and painful excoriated areas; nevertheless a tic had
sprung from the habit, and it remained inveterate.
Another analogous case is quoted by the same observers[101]:
Public-domain text, read in full here on John Shaqi.
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