TICS and Their Treatment

Medical > General

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by Henry Meigne (Author), E. Feindel (Author), S.A.K. Wilson (Translator)

PREFACE

NOTHING could be less scientific than the establishment of a hierarchy among medical problems based on the relative severity of symptoms. Prognosis apart, there can be no division of diseases into major and minor.

Hitherto no great importance has been attached to those reputedly harmless "movements of the nerves" known as tics: an involuntary grimace, a peculiar cry, an unexpected gesture, may constitute the whole morbid entity, and scarcely invite passing attention, much less demand investigation. Yet it is the outcome of ignorance to relegate any symptom to a secondary place, for we forget that difficult questions are often elucidated by apparently trivial data. A fresh proof of the truth of this remark is to be found in the accompanying volume, to which MM. Meige and Feindel have devoted several years of observation.

To begin with, they must be congratulated on having done justice to the word tic. No doubt its origin is commonplace and its form unscientific, but its penetration into medical terminology is none the less instructive. If popular expression sometimes confounds where experts distinguish, in revenge it is frequently so apt that it forces itself into the vocabulary of the scientist. In the case under consideration Greek and Latin are at fault. The meaning of the word tic is so precise that a better adaptation of a name to an idea, or of an idea to a name, is scarcely conceivable, while the fact of its occurrence in so many languages points to a certain specificity in its definition.

Yet till within recent years tic had all but disappeared from the catalogue of diseases. A closer study of reflex acts, however, has led to the grouping together of various clonic convulsions of face or limbs, including "spasms" on the one hand, and, on the other, conditions of an entirely different nature, for which the term "tics" ought to be reserved. The separation of "tics" from "spasms," properly so called, has been the object of various experiments and observations made by the authors and by myself, the practical value of which is evidenced by their disclosure of efficacious therapeutic measures.

Among the confused varieties of spasm, clonus, hyperkinesis, etc., it is impossible not to recognise the obvious individuality of certain motor affections—certain movements of defence, of expression, of mimicry, certain gestures more or less co-ordinated for some imaginary end—all readily distinguishable from spasms, fibrillary contractions, and choreiform or athetotic movements. It is only logical to attribute a somewhat more complex origin to these varying gestures, in which the influence of the will, however unperceived in the end, is always to be detected at the beginning.

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