I am conscious of very material gain. I do not tic so often or with such force. I know how to keep still. Above all, I have learned the secret of inhibition. Absurd gestures that I once thought irrepressible have succumbed to the power of application; I have dispensed with my para-tic cane; the callosities on my chin and nose have vanished; and I can walk without carrying my head in the air. This advance has not been made without a struggle, without moments of discouragement; but I have emerged victorious, strong in my knowledge of the resources of my will.... To tell the truth, at my age I can scarcely hope for an absolute cure. Were I only fifteen, such would be my ambition; but as I am, so shall I remain. I very much doubt whether I shall ever have the necessary perseverance to master all my tics, and I am too prone to imagine fresh ones; yet the thought no longer alarms me. Experience has shown the possibilities of control, and my tics have lost their terror. Thus have disappeared half my troubles.
The same sagacity that O. displayed in analysis of his tics has enabled him to grasp the principles of their subjugation. Notwithstanding that his guarded prognosis is evidence for his appreciation of the hindrance his peculiar mental constitution is to a complete cure, he has impartially put on record his definite progress towards health of body and mind.
Such, then, is the faithfully reported story of our model, such are his confessions.
During ten years' intercourse with sufferers from tic it has been our interest to analyse and reconstruct the pathogenic mechanism of their symptoms, and in the vast majority of cases it has been possible to determine the origin of the tics and to confirm the association with them of a peculiar mental state. We have thus been able to supplement earlier and weighty contributions to the subject by numerous suggestive instances, prominent among which is the case of O., whose spontaneous and impartial self-examination forms an invaluable clinical document. Its importance is enhanced by the fact that its observations are corroborated by a survey of other examples of the disease.
With commendable good-humour, keenness, and sincerity, O. has of his own accord plunged into the minutiæ of his malady, and exhibited a rare appreciation and precision in the scrutiny of his symptoms. The mere enumeration of them stamps the record as one of outstanding clinical importance, but it is the study of their pathogeny that is so fascinating. For a moment the doubt crossed our mind that O.'s explanations might be merely a reflex of information culled from scientific journals or of conversations with medical friends, but this is not so. He has been prevented by his profession both from cultivating a taste for and from devoting any leisure to psychological and physiological questions, while he evinces an actual antipathy to medical literature, fearful as he is of contracting disease. The point we are desirous of emphasising, therefore, is simply this: that the results of O.'s voluntary and unprejudiced self-examination are in perfect harmony with the declarations of our older patients and with the statements of the majority of those that have made a special study of the tics. For these reasons we have taken O. as the prototype of the tiqueur.
CHAPTER II
HISTORICAL
WE have just become acquainted with an individual who may, we believe, be considered the type of a species, and have described all his tics. What is a tic, then?
Its etymology has not much information to furnish. The probability is that the word was originally onomatopœic, and conveyed the idea of repetition, as in tick-tack. Zucken, ziehen, zugen, tucken, ticken, tick, in the dialects of German, tug, tick, in English, ticchio in Italian, tico in Spanish, are all derivatives of the same root. It matters little, in fact, since the term is in general use and acceptable for its shortness and convenience. In popular language every one knows what is meant by a tic: it is a meaningless movement of face or limbs, "an habitual and unpleasant gesture," as the Encyclopædias used to say. But the definition lacks precision.
A glance at the history of the word will reveal through what vicissitudes it has passed. We need but remind the reader of its exhaustive treatment in the Dictionaries, and refer him for an elaborate bibliography to a recent work by R. Cruchet,[1] to which we shall have occasion to return.
There is no justification for regarding the risus sardonicus of the ancients as a tic. All that we can say is that the phrase apparently stood for a complex of facial "nervous movements," whether accompanied by pains and paralyses or not. Nor can the rictus caninus or the tortura oris have been other than spasms or oontractures of the face.