Here there seems to have been a combination of hysteria with the disease
of convulsive tics. Charcot,[156] however, drew a sharp line of
distinction between them, although they may co-exist in the same
individual.
Apropos of this subject Raymond and Janet[157] call attention to the
fact that in the somnambulistic state the memory may be much more
extensive than in the waking state, and may recall events that have not
passed the threshold of consciousness, which nevertheless have been the
determining cause of various phenomena of the conscious life. In this
way may be explained the genesis of certain tics, although it is not a
necessary sequel that they themselves are stigmata of hysteria.
Sometimes, however, that disease does appear to play an indispensable
part in originating convulsive movements. An interesting case in point
has been published by Scherb[158] as "beggar's tic."
The patient is a young girl eighteen years old, born of an
alcoholic father and an hysterical mother, and brought up amid
deplorable surroundings, socially and morally. At the age of seven
she contracted diphtheria, and a doctor was called to visit her.
The mere sight of him so frightened her that the whole of the right
side of her body went into a state of contracture, with mouth and
eye deviated to the right, the arm pronated and adducted, the leg
stiff and the heel raised off the ground. Some gradual improvement
took place after a month, but her mother saw in the incident a
means of attracting public sympathy, and encouraged the child to
maintain the vicious attitude by sending her into the streets to
beg. And so she appears to-day, her right foot trailing, her toes
flexed, her forearm bent, her hand extended and fingers curled up.
Whenever the patient is unobserved or forgets her professional
attitude, at once the arm resumes its normal position and activity.
An examination of sensation reveals a hyperæsthesia of the right
half of the body, with _points douleureux_ over the left ovary and
the left mamma, as well as over the larynx. There is no contraction
of the visual fields; reflectivity is normal; Babinski's sign is
absent.
The author considers the case one of "professional mental tic" in a
predisposed patient--in other words, the tic is a "mental bad habit" in
an individual psychically abnormal.
There is a certain analogy between this condition and mental torticollis
in the insignificance of the effort by which the patient corrects the
deformity, compared with the great force exerted by any one else to
obtain the same result. Yet the symptoms strongly suggest hysteria;
their unilaterality, and the combination of motor and sensory
alterations, are altogether too special to have been caused by any other
morbid process.
Public-domain text, read in full here on John Shaqi.
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