By Howard I. Kushner

Over a century and a part in the past, a French doctor said the unusual habit of a tender aristocratic lady who could without notice, suddenly, erupt in a startling healthy of obscene shouts and curses. a dead ringer for the stricken Marquise de Dampierre echoes in the course of the a long time because the emblematic instance of an sickness that at the present time represents one of many fastest-growing diagnoses in North the US. Tourette syndrome is a suite of behaviors, together with recurrent ticcing and involuntary shouting (sometimes cursing) in addition to obsessive-compulsive activities. The interesting heritage of this syndrome finds how cultural and scientific assumptions have made up our minds and notably altered its characterization and therapy from the early 19th century to the current. A Cursing mind? lines the not easy type of Tourette syndrome via 3 specific yet overlapping tales: that of the claims of clinical wisdom, that of sufferers' reports, and that of cultural expectancies and assumptions. previous researchers asserted that the unusual ticcing and impromptu vocalizations have been psychological--resulting from sustained undesirable conduct or loss of strength of mind. this present day, sufferers showing those behaviors are obvious as being affected by a neurological ailment and customarily are handled with drug treatment. even if present medical examine exhibits that Tourette's is an natural affliction, this pioneering background of the syndrome reminds us to be skeptical of scientific orthodoxies in order that we could remain open to clean understandings and more suitable interventions. (20001209)

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50 Perhaps the clearest midcentury statement of the view that a predisposing rheumatic cause undercut the need for construction of separate syndromes for each variety of motor movements was made in 1851 by C. M. S. Sandras, of the Faculty of Medicine of Paris. 51 Acute chorea, according to Sandras, was less common, yet more progressive and lethal than chronic chorea, which manifested itself either as general or partial (convulsive). General chronic chorea ªt Sydenham’s chorea, while Sandras’s examples of partial or convulsive chorea (which he also called “convulsive tics”) meshed with those involuntary tics and vocalizations that would become classiªed later as Gilles de la Tourette’s tic disease.

55 Thus, only two of Gilles de la Tourette’s clinical observations displayed the range of symptoms that he and Charcot attached to the general syndrome. None, however, ªt their assertions that the syndrome was unambiguously progressive and lifelong. Indeed, the twenty-year-old civil servant, S. , who had exhibited ºorid symptoms, was completely free of them (except some residual word repetition) the year after Gilles de la Tourette examined him. In this context, then, the example of the Marquise de Dampierre was essential as evidence for Gilles de la Tourette’s claim that he had described a syndrome that must be distinguished from other seemingly similar disorders.

66 Detroit physician W. M. Donald noted in 1892 that among physicians there was widespread agreement that rheumatism and chorea, in terms of “cause and effect stand so closely interrelated, that no room for doubt is left in the mind of even the most superªcial observer . . ”67 Even those who argued that rheumatic fever was only one possible cause of chorea never completely dissociated the two. For instance, Dr. ” Nevertheless, Pagliano cited “the words of M. ”68 Because late twentieth-century Western medicine has adopted Charcot’s typology of movement disorders, historians of medicine and clinical practitioners have neglected the late nineteenth-century medical discussion about the possible infectious substrate of these disorders.

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