Sometimes there is not merely co-existence, but an actual parallelism between the motor and the psychical disturbance. I have under observation at present a young woman suffering from attacks of agitation, with delusions and hallucinations, who has developed a facial tic in the course of her psychosis, and increase in the violence of the tic is associated with abrupt utterance of imperfectly formed syllables. During the last two months she has been having attacks in the evening, when the psychical troubles have become more intense, and simultaneously there has been aggravation of the tic and incessant emission of laryngeal sounds and syllables. Here then is a parallelism between the two groups of symptoms. I am disposed, however, to believe that the usual prognosis given where motor and mental defects co-exist is too guarded. I have seen the catatonia of dementia præcox disappear spontaneously, in spite of its intensity and the unfavourable outlook prophesied by all who had seen the case. In distinction, then, from the value of a knowledge of the patient's mental condition, we consider the motor reactions of tic of little prognostic significance. CHAPTER XVIII THE TREATMENT OF TICS THE CURABILITY OF TICS Tics are commonly held to be trivial affections of but passing medical interest, while in addition they have gained the notoriety of being peculiarly rebellious to treatment. Such undeserved criticism is at once too superficial and too severe. As far as life is concerned, the prognosis is favourable, but they often contrive, quite as forcibly as many graver diseases, to render existence intolerable. To neglect them or to consider them _a priori_ incurable is entirely unwarranted. Some degree of amelioration is practically always attainable, and even complete cures may be effected. It is an old doctrine this of the incurability of tic, but the sufferers have not always been left to their fate. Forecasts of methods of treatment likely to ensure success were made long ago. In the "Dictionary in Sixty Volumes" of the year 1821 will be found a definition of tic, a little out of date perhaps, but affording a glimpse of therapeutic possibilities: "The word tic is ordinarily employed to designate certain unnatural habits, bizarre attitudes, peculiar gestures, etc., whose correction demands a painstaking perseverance that is not always sufficient to procure the desired result."