Every physical and every mental anomaly is the fruit of degeneration;
every individual who is a departure from the normal is a degenerate,
superior or inferior as the case may be. As instances of the latter we
may specify the dwarf and the weak-willed; of the former, the giant and
the exuberant. This sane and comprehensive conception of the subject
must command universal acceptance as a synthetic dogma, but it cannot
supplant the description and interpretation of individual facts. However
legitimate be our representation of tic as a sign of degeneration, it is
obviously inadequate if we rest content with styling its subject a
degenerate.
Unfortunately the inclination too often is to be satisfied with the
term, and to imagine that therewith discussion terminates. Still more
unfortunately, in concentrating their attention on the mental aspect of
the disease, some have altogether lost sight of one of its fundamental
elements, viz. the motor reaction, and have conceived the possibility of
its occurrence without any _tic_ at all. Cruchet actually postulates the
existence of an exclusively psychical tic, with no external
manifestation.
To these questions, however, we shall return. The present introductory
sketch is intended merely to demonstrate the ease with which ambiguity
arises, and the desirability of its removal. We are fully conscious of
the value of the work of Magnan and his school in emphasising a phase of
the subject the exposition of which can only result in gain.
* * * * *
The investigation of the motor phenomena of tic is no less encircled
with perplexities. Not only are the troubles of motility boundless in
their diversity and correspondingly difficult to classify, but they also
bear so close a resemblance to a whole series of muscular affections
that one is tempted to describe a special symptomatology for each
individual case.
For several years there has been, more especially outside of France, a
manifest tendency to aggregate all convulsions of ill-determined type
into one great class, under the name "myoclonus"; and into this chaotic
farrago, it is to be feared, will tumble a crowd of conditions which
should be studiously differentiated: the tics, electric and fibrillary
choreas, paramyoclonus multiplex, etc., etc.
In the present state of our knowledge, according to Raymond,[5] we must
be guided by the lessons of clinical experience, which teach us, first,
that the varying modalities of myoclonus develop from the parent stock
of hereditary or acquired degeneration; and, secondly, that transitional
forms which do not fall into any of the received categories are of
common occurrence.
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