A CURSING BRAIN?

A well-documented, scholarly analysis of the changing ways in which practitioners have tried to explain the baffling phenomenon of motor tics and involuntary shouts, barks, and curses exhibited by those with Tourette syndrome. Kushner, a medical historian (San Diego State Univ.) grounded in neurobiology and neurochemistry, opens with the “case of the cursing marquise,” a French noblewoman whom the Parisian neurologist Georges Gilles de Tourette chose in 1885 as his exemplar of the illness he labeled “maladie des tics.” Tourette considered it to be both progressive and hereditary. The standard work on the subject for the first half of this century, Tics and Their Treatment, assumed that heredity combined with habit and weakness of will to produce the symptoms. In the psychoanalytic view, the bizarre behaviors were seen as one possible outcome of a narcissistic, repressed childhood sexuality. In the 1920s and ’40s the conflicting view that tics had an organic basis was given support by the connection that had been established between focal infections and other motor disorders. Kushner traces how these differing views of Tourette’s causes shaped not only patients’ and physicians’ perception of the disorder but also its treatment: psychotherapy, lobotomies, removal of teeth or tonsils—all were tried and claims made for their effectiveness. The psychoanalytic approach, while still holding sway in France, has now given way to the organic view in the US and Great Britain, and Kushner recounts the role of the Tourette Syndrome Association in publicizing this view and lobbying for research funding to determine the brain mechanisms involved and to find effective drug treatments. His skeptical conclusion that the success and decline of the various approaches owes more to the power of a shared set of beliefs than to the rigor of scientific testing is persuasive. A fascinating document for medical history buffs, albeit a sometimes disturbing one for Touretters and their families. (10 photos, 2 illustrations, not seen)