In tics of the limbs, shoulders, hands, feet, innumerable movements will
suggest themselves for practice. The young girl with a tic of
genuflexion, under the care of Oddo, supplies an excellent proof of the
value of Brissaud's method:
The immobilisation of movements was realised by the mother forcing
the child to remain motionless in a fixed position for augmented
periods. As for movements of immobilisation, the patient made
peregrinations of increasing length under the mother's eye, the
order being repeatedly given to suppress the genuflexions. At the
same time, massage and passive movements to the limbs and joints
were prescribed, with a view to diminishing the articular
cracks--the exciting cause of the bizarre tic from which the girl
suffered.
In the course of ten or twelve days the genuflexions had entirely
vanished, and a return of the pain in the coxo-femoral articulation
aided materially in consolidating the effects of the treatment.
Tics of speech should be handled in the same way as stammering. "We do
not treat stammerers, we educate them," says Moutard-Martin. There can
be no gainsaying the convincing results obtained by Chervin's technique.
For years there has been unanimity of opinion on the value of
respiratory gymnastics in the treatment of stammering. The plan is to
make the patient inspire deeply and quickly, and follow this with a
prolonged expiration. Difficulties of articulation and phonation may be
overcome by recitation, by declaiming, by scanning utterance, by
dwelling on the vowels, etc. Various authors have laid stress on the
advisability of concomitant therapeutic treatment.
In cases of stammering (says Olivier), all surgical interference is
to be deprecated. Operations on the nose or throat are directed
toward the removal of obstructions in the air-ways, but they are
merely a preparatory step to the adoption of the education method.
No one of the vaunted "cures" for stammering is infallible, since
all depend in the last resort on the will power of the patient, nor
is there anything mysterious about them. Isolation is not always
indicated; what is indispensable is reinforcement of the will.
The intimate relation between tics of speech and various kinds of
stammering has led to the application to both of the same re-education
methods. Pitres,[226] in particular, bases his line of treatment for
tics in general on regulation of respiratory activity, as he has
observed that tics diminish or die away with a deep and regular
respiratory rhythm. His plan is as follows:
Supported against a wall, with shoulders braced back, the patient
is instructed to take slow and deep inspirations, raising his arms
the while, and letting them fall with expiration. This performance
is repeated three times a day, for ten minutes at a time.
Public-domain text, read in full here on John Shaqi.
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