These traits in the child's character pertain equally to the patient
with tic, in whom retarded or arrested development of volition, physical
and mental evolution otherwise being normal, is the principal cause of
faulty mental balance. That this view is correct may be inferred from a
comparison of the individual patient with healthy subjects of his own
age. The chief element in mental infantilism is maldevelopment of the
will. While in the child deficiency of what one might call mental
ballast is usually atoned for by well-conceived discipline and
education, it is accentuated by misdirected teaching. Now, it not
infrequently happens that the upbringing of the predisposed to tic is
not all that might be desired, seeing that mental defect on the part of
the parents renders them unsuitable as instructors of youth. Parental
indulgence or injustice is the fertile source of ill-bred or spoiled
children, in whom, spite of years, persist the mental peculiarities
proper to childhood. From the ranks of these spoiled children is
recruited the company of those who tic, for tics, generally speaking,
are nothing more than bad habits, which, in the absence of all
restraining influence, negligence and weakness on the side of the
parents have allowed to degenerate into veritable infirmities. These the
patients themselves are incapable of inhibiting, for whatever be their
age, they remain "big children," badly bred and capricious, and ignorant
of any self-control. Hence one of the first indications in their
treatment is to submit them to a firm psychical discipline, calculated
specially to strengthen their hold over their voluntary acts. Take the
following case:
J. is nineteen years old, intelligent, educated, ready to graduate
were it not for the interruptions his studies have undergone, and
to all appearance arrived at manhood's estate. None the less he
presents to-day the mental condition of nine years ago: he is
fickle, pusillanimous, naïve, emotional; he laughs at trifles and
is provoked to tears at the first harsh word; his nature is
restless, his mind inconsequential; he is by turns elated or
depressed for the most trivial of reasons. Notwithstanding his
seventy-one inches, he must still be fed, dressed, and put to bed
by his mother!
An identical mental state obtains in infantilism, properly so called,
where to arrest of mental development physical imperfection is
superadded. In cases of infantilism the psychical level corresponds more
or less intimately to the somatic level, an observation borne out in the
case of J.:
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