Disobedience to the law in the shape of exaggeration or redundance of
purposive movement indicates functional excess. For instance, the object
of the function of nictitation is to moisten the conjunctiva. In its
evolution the child's unmethodical reaction gives place to the
rhythmical automatism of the adult. Perfection is the fruit of
education.
But the person whose impetuous and uninterrupted blinking far exceeds
the demand of the eye for lubrication is plainly troubled with excess,
with "hypertrophy" of function. Herein may consist a tic, and, in fact,
a large number of tics are nothing more than functional derangements of
this kind.
The execution of a functional act at an inopportune moment constitutes
another variety of functional disorder. A smile with no pleasant thought
to correspond; a cry, a word, that betoken no precise idea; a gesture to
relieve an irritation that does not exist; a chewing movement when the
mouth is empty--all are examples of untimely, inappropriate functional
acts, which merit the name of tics if in addition they are anomalous as
regards rhythm, amplitude, and intensity.
Again, the performance of function is accompanied by antecedent desire
and subsequent satisfaction. Authoritative proof of this law is
furnished by the case of micturition and of defæcation, although
momentary suspension of the function of nictitation or of respiration is
also a sufficiently convincing mode of demonstrating its truth. In the
case of locomotion and other motor functions a preliminary feeling of
need may not be so imperative, but it is none the less constant.
Now, it has been observed already that these are equally conspicuous
features in our conception of tic. In so far, then, as the latter is
preceded by irresistible impulsion and followed by inordinate content,
it may be considered a functional affection.
We cannot, however, dispose of each and every tic as an anomaly of some
normal universal function. We have already had occasion to notice a
large number of functional acts that are not of general distribution,
so-called professional movements, which of course are liable to
derangement. Such functional disturbances may be styled professional
cramps, spasms, or neuroses; but are they identical with tics?
To attach the majority of them to the tics is, in our opinion,
justifiable. They are the clinical expression of abnormalities
supervening in a function that has by repetition acquired the automatism
of genuine functional acts: they are germane to the tics. In certain
points, however, the analogy is not absolute.
Professional cramps are motor phenomena distinguished by arrest of
intended movement. Spasm signifies excess of motor reaction, cramp
denotes its inhibition. It cannot, then, be said that they present the
characteristic features of spasm as we have defined it: they are akin
rather to a form of tonic tic of which we shall give instances later.
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