Stand or sit in front of a mirror and endeavour to maintain an absolutely correct position of trunk and shoulders.
Lift the arms vertically and turn the head to the right, then lower the arms while the head remains as it is.
Bend the body forward, and stretch the arms out till they touch the ground, the head meantime being rotated to the right. Then rise up again with the head in the same attitude. After two or three efforts it will be found that the head can be kept straight for a few seconds.
In tics of the limbs, shoulders, hands, feet, innumerable movements will suggest themselves for practice. The young girl with a tic of genuflexion, under the care of Oddo, supplies an excellent proof of the value of Brissaud's method:
The immobilisation of movements was realised by the mother forcing the child to remain motionless in a fixed position for augmented periods. As for movements of immobilisation, the patient made peregrinations of increasing length under the mother's eye, the order being repeatedly given to suppress the genuflexions. At the same time, massage and passive movements to the limbs and joints were prescribed, with a view to diminishing the articular cracks—the exciting cause of the bizarre tic from which the girl suffered.
In the course of ten or twelve days the genuflexions had entirely vanished, and a return of the pain in the coxo-femoral articulation aided materially in consolidating the effects of the treatment.
Tics of speech should be handled in the same way as stammering. "We do not treat stammerers, we educate them," says Moutard-Martin. There can be no gainsaying the convincing results obtained by Chervin's technique.
For years there has been unanimity of opinion on the value of respiratory gymnastics in the treatment of stammering. The plan is to make the patient inspire deeply and quickly, and follow this with a prolonged expiration. Difficulties of articulation and phonation may be overcome by recitation, by declaiming, by scanning utterance, by dwelling on the vowels, etc. Various authors have laid stress on the advisability of concomitant therapeutic treatment.
In cases of stammering (says Olivier), all surgical interference is to be deprecated. Operations on the nose or throat are directed toward the removal of obstructions in the air-ways, but they are merely a preparatory step to the adoption of the education method. No one of the vaunted "cures" for stammering is infallible, since all depend in the last resort on the will power of the patient, nor is there anything mysterious about them. Isolation is not always indicated; what is indispensable is reinforcement of the will.
The intimate relation between tics of speech and various kinds of stammering has led to the application to both of the same re-education methods. Pitres,[226] in particular, bases his line of treatment for tics in general on regulation of respiratory activity, as he has observed that tics diminish or die away with a deep and regular respiratory rhythm. His plan is as follows: