We should like, however, to allude to a matter of clinical observation
that we frequently have had occasion to remark. What simulates muscular
enfeeblement in the subject of tic is often nothing else than a want of
accuracy and _adresse_ in the performance of a given movement. For
instance:
S. enjoys robust health; his only trouble is a lack of accurate
control over his limbs. His execution of the most elementary
movements is incorrect. There is no tremor, no jerkiness, simply a
loss of the sense of position. He never knows whether he is holding
himself straight, whether his arms are exactly horizontal or his
shoulders symmetrical. Often he confuses right and left, and when
requested to perform some act on one side, he declares he is
tempted to perform it simultaneously on both. The order to fold his
arms and rotate the upper part of his body to the right evokes an
inconceivable display of contortions. In the attempt to bend his
head and body backward, fear of losing his balance causes him to
twist and turn about most strangely, and the remark that all this
he might avoid by merely putting one foot further back seems to
cause him infinite surprise.
Or again:
The absence of precision in Mademoiselle R.'s movements, her habit
of arresting the action before attaining the desired end, are not
to be ascribed to any feeling of discomfort, but to her ignorance
of the amplitude of her efforts, and of the position of her limbs.
Her acts are always feeble, hesitating, and curtailed, a curious
mixture of muscular languor and vigilance, "as if she were afraid
of breaking herself." She appears to be constantly seeking some new
position for herself, and to be as constantly oblivious of her
actual attitude. With eyes closed, however, she indicates the
relation of her limbs exactly.
Another example is furnished by the case of L., to which reference is
made on p. 135.
There is no call to multiply instances. Enough has been said to
demonstrate the frequent occurrence, if not of motor inco-ordination, at
least of faulty orientation in space and of defective estimation in
regard to the range and intensity of voluntary movements, among the
subjects of tic. The topic is a very interesting and fruitful one, on
which considerable light may be thrown by the application to it of the
results of Pierre Bonnier's[54] remarkable studies on the sense of
attitudes, a subject that we intend to develop on another occasion.
FREQUENCY AND RHYTHM--RHYTHMIC TIC
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