M. Cruchet, of Bordeaux, to whom frequent reference is made in this
volume, has in several communications on tic expressed himself at some
length, and some of these have made their appearance since the
publication of _Les tics et leur traitement_. According to him, the
original meaning of the word "tic" is a movement arising in a "bad
habit," and there would never have been any confusion had the term "tic
douloureux" not been introduced. We know well enough the exact
significance of this term, but its use led to, the adoption of the
cognate term "tic non-douloureux," and in the latter group two
absolutely different conditions have been confused--viz. true tics, and
spasms in Brissaud's sense. The difference between the two is now
recognised everywhere in France; but in England and America, as Risien
Russell points out in his article in Clifford Allbutt's _System of
Medicine_, tic is still applied to such conditions as facial spasm and
the involuntary movements of trigeminal neuralgia, whereas it should be
reserved for what we usually call "habit spasm" and "habit chorea." The
advantage of the word "tic" over these rather cumbrous terms must be
patent to the unbiassed mind.
It is, however, in his persistent affirmation that a tic, to be a tic,
must be clonic, that Cruchet disagrees with the tenets of Meige and
Feindel. He has abandoned the use of the term "organic tic" in favour of
spasm; and he maintains that "tonic tic" and "tic of attitude" should
give place to "habit attitude" and "convulsive attitude," as the case
may be. His definition of tic is in the following terms:
Tic consists in the execution--short, abrupt, sudden, irresistible,
involuntary, inapposite, and repeated at irregular but frequent
intervals--of a simple isolated or complex movement, which
represents objectively an act intended for a particular purpose.
Curiously enough, however much this definition emphasises the clonic
element in tic, Cruchet makes a subdivision into habit tics and
convulsive tics, of which the former "are exactly comparable to normal
movements, except that they are involuntary at the moment of their
execution, are performed for no reason or purpose, and their frequency
is unusual." Their difference from convulsive tics is merely one of
degree; a habit tic may become a convulsive tic, and some are convulsive
from the beginning. A habit tic, if the movement be a slow one, is
closely allied to the "attitude"; and it is not always practicable to
draw a distinction between them.
Thus Cruchet himself admits that the clonic element in tic may be
minimal, so that the differences between him and our authors are by no
means so insuperable as might be imagined. What he calls a habit tic is
equivalent to the stereotyped act of the others, who hold, it will be
remembered, that the movement of tic differs from the normal movement
not merely by being involuntary, irresistible, inapposite, and so on,
but also by being exaggerated.
Public-domain text, read in full here on John Shaqi.
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