A case has been recorded by F. Pick[124] of a man of thirty-eight years of age afflicted with convulsive movements of the face and troubles of speech.
Whenever the patient tried to speak oral contortions and deviation of the tongue ensued, and hands and feet began to beat the air without his being able to utter a single word. The agitation was increased by emotion and diminished with volitional movement.
Another instance is referred to by Aimé[125] under the name of tic of elocution, where the combination of convulsive movements of neck, shoulder, and arm with spasm of articulation of eight years' standing disappeared under the influence of methodical re-education.
Kopczynski cites the case of a man with facial and other tics who used often to utter a long string of words or even a whole sentence in an extremely monotonous voice, resuming his natural tone thereafter; occasionally, too, he used to pause in the middle of a remark for as long as forty seconds.
Mention must be made here of true spasms of phonation or laryngospasms, the result of local irritation, which disappear with its removal. Central lesions, of course, might conceivably produce the same effect.
Uchermann[126] has reported a case of recurrent attacks of mutism at intervals of five or ten minutes in a man of sixty-eight, examination of whose larynx during the seizure showed the glottis to be in spasm. Synchronously with these rhythmical clonic alternations of adduction and abduction occurred tonic contractions of the masseters and clonic contractions of the palate, tongue, and forearm. The phenomena had lasted for about a month when a right hemiplegia was superadded, and was followed by a fatal issue three weeks later. Unfortunately no autopsy was obtained to verify the observer's opinion of a lesion in the neighbourhood of the left precentral sulcus, involving the centres for mastication and phonation, for the tongue and for opening of the glottis.
If now we direct our attention to the content of speech, we shall see how it too may reveal anomalies not unlike tics.
Letulle quotes the case of a man who could not utter four consecutive words without sandwiching a "sir" between them. Similarly, the "don't you know," "do you see," "you know," of so many people are repeated ad infinitum. One of us has an acquaintance who interlards his talk with "you understand," and this formula is reiterated without modification though he may be addressing his friend in the second person singular.
There used to be a poor creature driven by destitution to sell papers in the streets, or to figure as a negro in the corridors of the Hippodrome, who was wont to garnish his speech with a "Well, my boy! all right, by Jove!" repeated at intervals, whoever it was he happened to be speaking to, and even though it was their first time of meeting.
In Ibsen's play of Hedda Gabler is a character George Tesman, a weak being who begins every sentence with "I say, Hedda," and ends with a no less invariable "eh!"[127]