With this premise, we can identify the professional cramp as a
functional anomaly recognisable by defective amplitude and force on the
part of the motor reaction. Its most special character is its appearance
exclusively during the exercise of the function of which it forms the
anomaly. Writers' cramp manifests itself in the act of writing, dancers'
cramp during dancing, and so on. We are ready to admit the close
affinity of professional cramp to tic, with which it has an additional
element in common in its occurrence among the psychically unstable. But,
regarded as a tic, it is unique in its dependence on the casual
exhibition of the professional act; as long as the telegraphist has no
occasion to transmit messages, his occupation cramp will not incommode
him in the least.
The great majority of genuine tics, on the other hand, are roused into
activity by anything or nothing, and this distinction is fundamental.
With all due recognition, therefore, of the marked resemblances between
the two, we shall be well advised in not confounding them under one
designation. For want of a better word, we shall use the phrase
professional cramp to specify functional disturbances taking place
solely during the discharge of professional acts.
One other class remains to be dealt with, consisting of functional acts
not merely superfluous but actually prejudicial to him who is at once
their creator and their slave. The idea that induced them and the object
they have in view are alike irrational.
An individual as he moves his arm one day becomes aware of a cracking
feeling in his shoulder-joint, and from the unwonted nature of the
sensation emanates the notion that he must have some form of arthritic
lesion. Renewal of the gesture is attended with reproduction of the
sound. The thought of a possible injury develops and extends until it is
an object of constant preoccupation and becomes a fixed idea. Under its
malign influence the movement is repeated a hundredfold and with growing
violence until it passes into the field of automatic action. It is
typically functional in its repetition, in the association of desire and
satisfaction; but it originates in an absurd idea, and is actuated by a
meaningless motive: its range is exaggerated, its performance
irresistible, and its reiteration pernicious. In fact, it is a tic.
We may thus regard tic as an obsolete, anomalous function--a _parasite
function_--engendered by some abnormal mental phenomenon, but obeying
the immutable law of action and reaction between organ and function, and
therefore just as prone to establish itself as any motor act of the
physiological order.
CHAPTER IV
THE MENTAL CONDITION OF TIC SUBJECTS
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