A no less characteristic feature of the subject of tic is his
impatience.
J. bolts his food without waiting to masticate it, and the instant
his plate is empty jumps up from the table to walk about the house.
He returns for the next course, which he swallows as precipitately;
delay makes him impatient, and all are forced to rush as he does.
Meal time for the whole family has become a perfect punishment.
Alarmed enough already at his tics, the parents are terror-stricken
by the tyrannical caprices of this big baby, who outvies the worst
of spoilt children in his behaviour.
Mental instability is not uncommonly associated with a general
restlessness and fidgetiness during intervals of respite from the actual
tics. The patient experiences a singular difficulty in maintaining
repose. Every minute he is moving his finger, his foot, his arm, his
head. He passes his hand over his forehead, runs his fingers through his
hair, rubs his eyes or his lips, ruffles his clothes, plays with his
handkerchief or with anything within reach, crosses and uncrosses his
legs, etc. None of these gestures can properly be considered a tic, for,
however frequent be its repetition, it is neither inevitable nor
invariable. If they are superfluous and out of place, the absence of
exaggeration or absurdity negatives their classification as choreic.
They are a sign not so much of motor hyperactivity as of volitional
inactivity. They are tics in embryo.
The patient's emotions are similarly ill balanced. Any rearrangement in
his habits he finds disconcerting; he is upset by an unexpected word, a
deed, a look; his timidity and sensitiveness are extreme--fertile soil
for the development of tics.
So, too, with his affections, his likes and dislikes, his friendships
and enmities--there is commonly a disproportion about them that betokens
mental deficiency. At one time it is fear or repulsion that actuates
him; at another it is an unnatural tenderness, a sort of _philia_, if
the term may be allowed.
Anomalies such as these, however, are met with in all the mentally
unstable, and do not present any special feature when they occur in
those who tic.
An acquaintance with the mental state of our patients enables us to
understand the mode their tic adopts. As one thinks, so does one tic. To
the transiency and mutability of the child's ideas correspond what are
known as variable tics, which rarely have a definite localisation, and
become fixed only when certain ideas become preponderant. The existence
of a solitary tic, however, is not at variance with that disposition we
have qualified as infantile, for mental infantilism is the original
stock; on it, as a matter of fact, may be grafted further mental
disorders in the shape of fixed ideas, phobias, or obsessions.
Public-domain text, read in full here on John Shaqi.
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