MALI-MALI, A MIMIC PSYCHOSIS IN THE PHILIPPINE 

 ISLANDS. A PRELIMINARY REPORT. 



By W. E. Musgeave and A. G. Sison. 



[From the Department of Clinical Medicine, Philippine Medical School, 

 Manila, P. I.) 



Between spasm on the one hand, with its more or less appreciable 

 physical patholog} 7 , and the true psychoses, with theoretic or intangible 

 mental pathology, on the other, there exists a neuropsychosis which is 

 interesting and important by reason of its prevalence and confusing 

 because of the illusiveness of its pathology. The habit spasm, habit 

 chorea, tic convulsif, of the French, and the other true tics, are found 

 toward the material or physical end of this group. Next comes Gilles 

 de la Tourette's disease, or impulsive tic, with its various manifestations 

 which appear to be real tics modified by a coexistent mimic habit. 

 Finally, the saltatory spasms, at least in part, possibly the myriachit of 

 Siberia, probably latah of Java, and surely mali-mali of the Philippines, 

 are not true tics, but directly and exclusively mimic habits. 



The underlying etiologic factor in all these conditions probably is 

 very similar : They are expressions of degeneracy. However, the clinical 

 types are so numerous and vary so greatly that in the absence of a 

 tangible pathology and etiology of these affections, much confusion, 

 particularly in nomenclature, exists and not much order will be possible 

 until the former are more definitely established. 



Spasm is defined by Meige and Feindel as "the motor reaction consequent on 

 stimulation of some point in a reflex spinal or bulbo-spinal arc. The irritation 

 provocative of the spasm is itself of pathological origin, and no spasm can occur 

 without it." If this definition is accepted, spasm should be less frequently con- 

 founded with tic than often is the case, notwithstanding the close relationship 

 and the rather frequent association of the two conditions in the same individual. 



Tics are less definite. Charcot * considered tic as a psychic disease in a physical 

 guise, the direct offspring of mental imperfection. Ballet = believes that the vast 

 majority of sufferers from tic belong to a class which he designates as "superior 

 degenerates." "The striking feature of these 'superior degenerates' or unstables 



'Lecons du mardi (1887-88), 124. 

 2 Traite de medecine, 6. 



335 



