TICS AND THEIR TREATMENT
T I C S · A N D
THEIR TREATMENT
BY HENRY MEIGE AND E. FEINDEL
With a Preface by
Professor Brissaud
TRANSLATED and EDITED, with a CRITICAL APPENDIX
BY S. A. K. WILSON, M.A., M.B., B.Sc.
Resident Medical Officer, National Hospital for the Paralysed and Epileptic.
Queen Square, London
NEW YORK
WILLIAM WOOD AND COMPANY
1907
COPYRIGHTED 1907 BY SIDNEY APPLETON
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ALL RIGHTS RESERVED
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PRINTED IN GREAT BRITAIN
PREFACE
NOTHING could be less scientific than the establishment of a hierarchyamong medical problems based on the relative severity of symptoms.Prognosis apart, there can be no division of diseases into major andminor.
Hitherto no great importance has been attached to those reputedlyharmless "movements of the nerves" known as tics: an involuntarygrimace, a peculiar cry, an unexpected gesture, may constitute the wholemorbid entity, and scarcely invite passing attention, much less demandinvestigation. Yet it is the outcome of ignorance to relegate anysymptom to a secondary place, for we forget that difficult questions areoften elucidated by apparently trivial data. A fresh proof of the truthof this remark is to be found in the accompanying volume, to which MM.Meige and Feindel have devoted several years of observation.
To begin with, they must be congratulated on having done justice to theword tic. No doubt its origin is commonplace and its formunscientific, but its penetration into medical terminology is none theless instructive. If popular expression sometimes confounds whereexperts distinguish, in revenge it is frequently so apt that it forcesitself into the vocabulary of the scientist. In the case underconsideration Greek and Latin are at fault. The meaning of the word ticis so precise that a better adaptation of a name to an idea, or of anidea to a name, is scarcely conceivable, while the fact of itsoccurrence in so many languages points to a certain specificity in itsdefinition.
Yet till within recent years tic had all but disappeared from thecatalogue of diseases. A closer study of reflex acts, however, has ledto the grouping together of various clonic convulsions of face or limbs,including "spasms" on the one hand, and, on the other, conditions of anentirely different nature, for which the term "tics" ought to bereserved. The separation of "tics" from "spasms," properly so called,has been the object of various experiments and observations made by theauthors and by myself, the practical value of which is evidenced bytheir disclosure of efficacious therapeutic measures.
Among the confused varieties of spasm, clonus, hyperkinesis, etc., it isimpossible not to recognise the obvious individuality of certain motoraffections—certain movements of defence, of expression, of mimicry,certain gestures more or less co-ordinated for some imaginary end—allreadily distinguishable from spasms, fibrillary contractions, andchoreiform or athetotic movements. It is only logical to attribute asomewhat more complex origin to these varying gestures, in which theinfluence of the will, however unperceived in the end, is always