An apparent lack of harmony between the rival hypotheses is, we shall
see, due rather to a difference in the interpretation of certain terms
than to a real opposition of ideas.
Brissaud's view that the tic is a co-ordinated automatic act and
consequently cortical is objected to by Grasset. Every automatic
co-ordinated act is not of necessity cortical. Conjugate deviation of
the head and eyes may be of bulbar origin; certain spinal movements even
may be no less co-ordinated and automatic. The decerebrate animal's walk
may be perfect in its co-ordination.
Careful analysis shows the divergence of opinion to arise merely from a
differing significance attached to the word origin. Brissaud is
considering the origin of the tic in time, at the moment of its
appearance; Grasset its origin in space, at the seat of its production.
Once the tic is constituted, its repetition each moment is a
manifestation of polygonal activity, but it is none the less true that
the movement which has degenerated into a tic had its source in
cortical, _i.e._ psychical, activity.
Any one who appreciates the import of Grasset's ideas will readily
understand his terminology; it is at the same time expedient that the
possibility of ambiguity in the use of words etymologically synonymous
should be avoided. Now, however judicious be the distinction he draws
between psychical and mental, it is to be feared it is not always
adequately grasped: we do not intend, therefore, to employ either mental
or psychical tic in our vocabulary, still less "psycho-mental" tic
(Cruchet). As for bulbo-medullary tic, it appears to us to be identical
with spasm as we have defined it, unless indeed it is to be taken as
signifying a tic begotten of a spasm, in which interpretation Grasset
and Brissaud both acquiesce.
TIC AND FUNCTION
We must now pass on to elaborate our conception of tic as a disordered
functional act.
The term function is employed to denote various biological phenomena
differing widely in manifestation and design. Vegetative functions such
as digestion, circulation, urination, etc., are regulated by a special
unstriped muscle system, the mechanism of which cannot be suspended by
cortical interposition; hence under no circumstances can its derangement
bring a tic into being.
Other functions, subserved by striped muscles, come within the range of
voluntary activity. Some--_e.g._ respiration--are essential to the
maintenance of life, and scarcely to be differentiated from those we
have called vegetative. Others, such as nictitation, mastication,
locomotion, are no whit less important, since their cessation, in the
absence of extraneous aid, would speedily have a detrimental effect on
the organism. They too are in a sense vital.
Others, again, such as expectoration, are useful, though not
indispensable. Some people labour under the disadvantage of being unable
to expectorate, but it is not a fatal defect. The function is not
universal.
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