In Ehret's view the fact of loss of volitional control argues the
psychical nature of the affection, and a similar opinion is held by
Thiem, Jacoby, and Wolff, who attribute the analogous cases they report
to a sort of traumatic neurosis in which the psychical element is
preponderant. Needless to remark, the patients in question were not
suffering from hysteria.
In this connection ought to be recalled the cases described by Raymond
and Janet[104] under the title of "tics of the foot."
The first was a woman thirty-seven years old, who as she walked
used slightly to invert her left foot, forcibly dorsiflex the great
toe, and separate the remaining toes widely one from the other.
Notwithstanding its painful nature, the condition had persisted for
seven years, and had originated in a very interesting way. She
happened to be undergoing a course of mercurial inunction at the
same time as she was troubled with a corn. The idea struck her that
perhaps the application of the ointment to the corn might prove
efficacious, but while trimming the latter some days later, she had
the misfortune to cut herself. Dread of the possible evil effects
of the injury was followed on the morrow by an accession of cramps
in the foot, the continuance of which led to the deformity that
ever since had made walking a misery.
The other patient was a young man twenty years of age, whose gait
used to be arrested, after a walk of ten minutes, by sudden and
vigorous plantar flexion of his right toes. Momentary repose
sufficed to make the spasm disappear, but it constantly recurred.
Re-education and psychotherapy effected a cure in each instance, so that
their psychical nature cannot be called in question, nevertheless the
painful character of the affections must not be forgotten, and since the
occasions of their manifestation were confined to the act of walking,
they correspond rather to "functional" or "professional cramps." In any
case, they cannot be confounded with the painful cramps of the calf
muscles that characterise certain toxæmias and infections (alcoholism,
cholera, etc.).
On the other hand, there can be no doubt of the existence of definite
tics of walking--widely varying functional derangements of tonic or
clonic type, distinguished by the unexpected interruption of ambulatory
rhythm.
We have met with a patient (says Guinon) who would abruptly halt
and bend his knees at though he had just received a violent blow on
the hock for which he was unprepared. To see him, one would have
thought he was about to sink to the ground.
Such tics of genuflexion are not particularly uncommon. Oddo[105] has
recently recorded a very instructive example, whose pathogeny he has
been at pains to elucidate.
Public-domain text, read in full here on John Shaqi.
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