A resin-gatherer of Landes carried all day from tree to tree a notched stake of wood by which to climb up the pine-trunks. The weight of it on his left shoulder began to cause a slight but persistent aching, which was followed by involuntary deviation of the chin to that side. The movements took place at the rate of ten to thirty a minute, but diminished materially in frequency and degree whenever the patient lay on his left side, or when he inclined his head voluntarily on either shoulder, and disappeared entirely if he was asleep, or if he sang, or whistled, or recited in a loud voice.
Examination of his visual fields revealed a marked restriction, and every effort to cure the condition proved ineffectual.
Pitres' conclusion is that the condition is one of tic, probably caused by the habit of carrying the stake, and probably also of hysterical origin. It is true the hysteria is reduced to its most simple elementary symptomatic expression, but it is difficult not to recognise its activity in the concentric contraction of the fields of vision.
Nothing is more likely, we think, than that we are dealing in this instance with a tic occasioned by a professional act, but we doubt whether alterations in the visual field are sufficient to justify a diagnosis of hysteria.
In another case of the same author, where a facial tic made its appearance in a hystero-neurasthenic after a series of worries, the association of the two is of course undeniable, but it does not follow that tic is in essence hysterical.
Take another example from Chabbert:
A little girl of twelve years, with a bad family history, began to exhibit involuntary movements as the result of a succession of frights, which led at the same time to the production of certain hysterical phenomena. The stigmata were unmistakable, and in addition the girl was an echolalic.
Here there seems to have been a combination of hysteria with the disease of convulsive tics. Charcot,[156] however, drew a sharp line of distinction between them, although they may co-exist in the same individual.
Apropos of this subject Raymond and Janet[157] call attention to the fact that in the somnambulistic state the memory may be much more extensive than in the waking state, and may recall events that have not passed the threshold of consciousness, which nevertheless have been the determining cause of various phenomena of the conscious life. In this way may be explained the genesis of certain tics, although it is not a necessary sequel that they themselves are stigmata of hysteria.
Sometimes, however, that disease does appear to play an indispensable part in originating convulsive movements. An interesting case in point has been published by Scherb[158] as "beggar's tic."