| PAGE | |
| PREFACE BY PROFESSOR BRISSAUD | [v] |
| AUTHORS' PREFACE | [xiii] |
| NOTE BY THE TRANSLATOR | [xv] |
| [CHAPTER I] | |
| THE CONFESSIONS OF A VICTIM TO TIC | [1] |
| [CHAPTER II] | |
| HISTORICAL | [25] |
| [CHAPTER III] | |
| THE PATHOGENY OF TIC | [36] |
| TIC AND SPASM | |
| TIC AND MOTOR REACTIONS; REFLEX, CO-ORDINATED, FUNCTIONAL,AUTOMATIC, AND VOLUNTARY ACTS | |
| TIC AND CO-ORDINATION | |
| THE GENESIS OF TIC | |
| TIC AND WILL | |
| TIC AND HABIT | |
| TIC AND IDEA | |
| TIC AND CONSCIOUSNESS | |
| TIC AND POLYGON | |
| TIC AND FUNCTION | |
| [CHAPTER IV] | |
| THE MENTAL CONDITION OF TIC SUBJECTS | [74] |
| [CHAPTER V] | |
| THE ETIOLOGY OF TICS | [96] |
| [CHAPTER VI] | |
| PATHOLOGICAL ANATOMY | [108] |
| [CHAPTER VII] | |
| STUDY OF THE MOTOR REACTION | [118] |
| THE TYPE OF MOTOR REACTION—CLONIC TIC AND TONIC TIC | |
| INTENSITY OF THE MOTOR REACTION | |
| FREQUENCY AND RHYTHM—RHYTHMIC TIC | |
| ATTACKS | |
| LOCALISATION OF THE MOTOR REACTION—VARIABLE TICS—FIXED TICS | |
| [CHAPTER VIII] | |
| ACCESSORY SYMPTOMS | [134] |
| REFLEXES | |
| ELECTRICAL REACTIONS | |
| VASOMOTOR AND SECRETORY AFFECTIONS | |
| AFFECTIONS OF SENSATION | |
| [CHAPTER IX] | |
| THE DIFFERENT TICS | [142] |
| FACIAL TICS—TICS OF MIMICRY | |
| TICS OF THE EAR—AUDITORY TICS | |
| TICS OF THE EYES—NICTITATION AND VISION TICS | |
| A. EYELID TICS | |
| B. EYEBALL TICS | |
| TICS OF THE NOSE—SNIFFING TICS | |
| TICS OF THE LIPS—SUCKING TICS | |
| TICS OF THE CHIN | |
| TICS OF THE TONGUE—LICKING TICS | |
| TICS OF THE JAWS—BITING TICS—TICS OF MASTICATIONMENTAL TRISMUS | |
| TICS OF THE NECK—NODDING AND TOSSING TICS—TICS OF AFFIRMATION,NEGATION, AND SALUTATION | |
| MENTAL TORTICOLLIS | |
| TICS OF THE TRUNK | |
| TICS OF THE ARM AND OF THE SHOULDER | |
| TICS OF THE HANDS—SCRATCHING TICS | |
| TICS AND WRITING | |
| TICS OF THE LOWER EXTREMITIES—WALKING AND LEAPING TICS | |
| SPITTING, SWALLOWING, AND VOMITING TICS—TICS OF ERUCTATIONAND OF WIND SUCKING | |
| TICS OF RESPIRATION—SNORING, SNIFFING, BLOWING, WHISTLING,COUGHING, SOBBING, AND HICCOUGHING TICS | |
| [CHAPTER X] | |
| TICS OF SPEECH | [206] |
| ECHOLALIA | |
| COPROLALIA | |
| [CHAPTER XI] | |
| THE EVOLUTION OF TICS | [221] |
| DISEASE OF GILLES DE LA TOURETTE | |
| VARIABLE CHOREA OF BRISSAUD | |
| [CHAPTER XII] | |
| ANTAGONISTIC GESTURES AND STRATAGEMS | [236] |
| [CHAPTER XIII] | |
| THE COMPLICATIONS OF TICS | [242] |
| [CHAPTER XIV] | |
| THE RELATION OF TICS TO OTHER PATHOLOGICAL | |
| CONDITIONS | [245] |
| TICS AND HYSTERIA | |
| TICS AND NEURASTHENIA | |
| TICS AND EPILEPSY | |
| TICS—INSANITY—IDIOCY | |
| THE TICS OF IDIOTS | |
| [CHAPTER XV] | |
| THE DISTINCTIVE FEATURES OF TICS | [260] |
| [CHAPTER XVI] | |
| DIAGNOSIS | [264] |
| TICS AND STEREOTYPED ACTS | |
| TICS AND SPASMS | |
| A. TIC OR SPASM OF THE FACE | |
| B. TIC OR SPASM OF THE NECK—TORTICOLLIS TIC AND TORTICOLLIS SPASM | |
| TICS AND CHOREAS | |
| A. SYDENHAM'S CHOREA | |
| B. HUNTINGTON'S CHOREA | |
| C. HYSTERICAL CHOREA | |
| D. ELECTRIC CHOREA, BERGERON'S CHOREA, DUBINI'S CHOREA, | |
| FIBRILLARY CHOREA OF MORVAN | |
| TICS AND PARAMYOCLONUS MULTIPLEX—TICS AND MYOCLONUS | |
| TICS AND ATHETOSIS | |
| TICS AND TREMORS | |
| TICS AND PROFESSIONAL CRAMPS | |
| [CHAPTER XVII] | |
| PROGNOSIS | [293] |
| [CHAPTER XVIII] | |
| THE TREATMENT OF TICS | [298] |
| THE CURABILITY OF TICS | |
| MEDICINAL TREATMENT | |
| DIET—HYGIENE—HYDROTHERAPY | |
| MASSAGE—MECHANOTHERAPY | |
| ELECTROTHERAPY | |
| SUGGESTION | |
| SURGICAL TREATMENT | |
| ORTHOPÆDIC TREATMENT | |
| [CHAPTER XIX] | |
| TREATMENT BY RE-EDUCATION | [315] |
| MIRROR DRILL | |
| REST IN BED | |
| ISOLATION | |
| PSYCHOTHERAPY | |
| ————— | |
| [APPENDIX] | [346] |
| [BIBLIOGRAPHY] | [351] |
| [INDEX OF NAMES] | [380] |
| [INDEX OF SUBJECTS] | [384] |
TICS AND THEIR TREATMENT
CHAPTER I
THE CONFESSIONS OF A VICTIM TO TIC
AT the time when the plan of our book was being sketched we decided to introduce the subject with several characteristic clinical documents, since it appeared to us indispensable to preface our definitions with an illustration of the type of affection and of patient that we had in view. The choice was rather bewildering at first; but towards the close of 1901 one of us was put into communication with an individual who is a perfect compendium of almost all the varieties of tic, and whose story, remarkable alike for its lucidity and its educative value, forms the most natural prelude to our study. The history is neither a fable nor an allegory, but an authenticated and impartial clinical picture, whose worth is enhanced by no less genuine facts of self-observation.
O. may be said to constitute the prototype of the sufferer from tic, for his grandfather, brother, and daughter have all been affected, and he himself has not escaped. His grandmother and grandfather were first cousins, and the latter, in addition to being a stammerer, developed tics of face and head; his brother stammers too, while both his sister and his daughter have facial tics, and one of his sons was afflicted with asthma as a youth. The family history therefore more than confirms the existence of a grave neuropathic heredity, an unfailing feature in cases of tic.
O.'s fifty-four years lie lightly on him. His physique and general health are excellent, and devotion to bodily exercise and outdoor sports has enabled him to maintain a vigour and an agility above the average; nor is his intellectual activity any less keen.
His earliest tics—simple facial grimaces and movements of the head—made their appearance when he was eleven years old; notwithstanding, his recollection of their mode of onset is very exact.
I have always been conscious of a predilection for imitation. A curious gesture or bizarre attitude affected by any one was the immediate signal for an attempt on my part at its reproduction, and is still. Similarly with words or phrases, pronunciation or intonation, I was quick to mimic any peculiarity.
When I was thirteen years old I remember seeing a man with a droll grimace of eyes and mouth, and from that moment I gave myself no respite until I could imitate it accurately. The rehearsals were not prolonged, as a matter of fact, and the upshot was that for several months I kept repeating the old gentleman's grimace involuntarily. I had, in short, begun to tic.