Should the cortex be functioning harmoniously, afferent impulse and
efferent reaction stand in due proportion one to the other; but any
disturbance of psychical equilibrium--_e.g._ the fixity of some idea
combined with inhibitory weakness--will effect a corresponding
disturbance on the motor side. Charcot used to speak of tics of the mind
revealing themselves by tics of the body. Fear may elicit a movement of
defence, to persist as a tic after the exciting cause has vanished.
It is of course quite incorrect to say that each and every motor
reaction to a pathological idea is a tic. The psychasthenic who in his
fear of draughts shakes the door-knob a hundred times a day to make sure
the door is shut, is not a martyr to tic; in spite of the absurdity of
his action, it is logically connected with the idea that originated it,
and it is the idea which is absurd. To make an involuntary movement of
defence against some purely imaginary ill, on the other hand, and to
continue when all fear is past, is to tic.
In practice it may not always be a simple matter to uphold the
distinction, but some such demarcation of the tic's limits is called for
if we are to avoid its being applied to any act performed under the
compulsion of a pathological mental state.
In its mildest form the mental trouble may consist of an ordinary
psychomotor hallucination, but if it be not projected as an objective
phenomenon it does not deserve to be called a tic. One of Séglas's
patients met a choreic woman undergoing electrical treatment in the same
room as herself; on leaving she felt as though her own right arm were
the seat of spasmodic movements similar to those of the choreic patient,
but as they did not betray themselves by any external sign they cannot
be considered tics.
The exteriorisation of the hallucinatory phenomenon suffices at once to
bring it within the scope of our definition. Innumerable tics arise in
this way, provoked, mayhap, by some or other insignificant psychomotor
hallucination. The attitude adopted by certain patients, as remarked by
Séglas, is an index to the nature and seat of their hallucinations. Some
keep their tongue firmly bitten between the teeth; others cram their
mouth with pebbles, or compress their epigastrium tightly, under the
impression that it is the source of their voice. Should such gestures
persist while the hallucination does not, they may give rise to what we
are in the habit of calling "tonic tics," or "tics of attitude," but we
must repeat that the presence of a convulsive element is essential;
however out of place or absurd the contractions are, if otherwise they
are normal we are dealing with what Séglas designates stereotyped acts.
To this question we shall return later.
TIC AND CONSCIOUSNESS
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