Apart from his studies in objective localisation, Trousseau, as we have
seen, recognised that the tic subject was mentally abnormal, but the
credit of demonstrating the pathogenic significance of the psychical
factor is Charcot's. Tic, he declared,[3] was physical only in
appearance; under another aspect it was a mental disease, a sort of
hereditary aberration.
Advance along the lines thus laid down has been the work more especially
of Magnan and his pupils, of Gilles de la Tourette, Letulle, and Guinon.
A meritorious contribution to the elucidation of the question is the
thesis of Julien Noir, written under the inspiration of Bourneville and
published in 1893. The still more recent labours of Brissaud, Pitres,
and Grasset in France, and of others elsewhere, have added materially
to our knowledge.
Confining ourselves for the present to the discussion of the latest
interpretations put on the word tic, we may be allowed the remark that
if the influence of Magnan's teaching has been instrumental in making
our idea of tic conform more to the results of observation, nevertheless
his view is not without its dangers.
In the opinion of Magnan and his pupils, Saury and Legrain[4] in
particular, the tics do not form a morbid entity; they are nought else
than episodic syndromes of what Morel called "hereditary insanity," that
is to say, of what is usually designated nowadays "mental degeneration."
Now, if by degeneration be meant a more or less pronounced hereditary
psychopathic or neuropathic tendency which betrays itself by actual
physical or psychical stigmata, then tic patients are unquestionably
degenerates. If degeneration unveils itself in multifarious psychical or
physical anomalies, the subjects of the tic are undoubtedly degenerates.
If a degenerate may suffer from one or other variety of aboulia, or
phobia, or obsession, the man with tic is a degenerate too.
Thus understood, the epithet may be applied to all individuals affected
with tic. In fact, they _must_ be degenerates, if the word is to be
employed in its most comprehensive sense. But the explanation is
insufficient, inasmuch as the converse does not hold good; all
degenerates do not tic.
We may be safe in maintaining, then, that tic is only one of the
manifold expressions of mental degeneration, but we are not much
enlightened thereby. Obsessions and manias similarly are indications of
mental deterioration, yet the fact conveys very scanty information as
to their real nature. Physical anomalies--ectrodactyly, for
instance--betoken physical degeneration, no doubt; but are inquiries to
cease with this categorical assertion? Such certainly was not the idea
of those observers whose is the praise for having demonstrated the
common parentage of the heterogeneous manifestations of degeneration.
Synthesis cannot exclude the work of analysis, and in practice there is
scarcely a case to which this doctrine is not pertinent.
Public-domain text, read in full here on John Shaqi.
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