OF ARTICULATE SOUNDS. 469 



a great variety of exciting causes. A disordered action of the nervous cen- 

 tres must, however, be regarded as the proximate cause ; though this may be 

 (to use the language of Dr. M. Hall) either of centric or of excentric origin, 

 that is, it may result from a morbid condition of the ganglionic centre, or 

 from an undue excitement conveyed through its afferent nerves. When of 

 centric origin (and this is probably the most general case), the phenomena of 

 Stammering and Chorea have a close analogy to each other ; in fact, stammer- 

 ing is frequently one of the modes in which the disordered condition of the 

 nervous system in Chorea manifests itself. It is in the pronunciation of the 

 Consonants of the explosive class, that the stammerer experiences the greatest 

 difficulty. The total interruption to the breath which they occasion, frequently 

 becomes quite spasmodic ; and the whole frame is thrown into the most dis- 

 tressing semi-convulsive movement, until relieved by expiration.* In the pro- 

 nunciation of the continuous Consonants of the first class, the stammerer 

 usually prolongs them, by a spasmodic continuance of the same action; and 

 there is, in consequence, an impeded, but not a suspended respiration. The 

 same is the case with the / and r in the second class. In pronouncing the m 

 and n, on the other hand, as well as the aspirates and vowels, it is sometimes 

 observed that the stammerer prolongs the sound, by a full and exhausting ex- 

 piration. In all these cases, then, it seems as if the muscular sense, resulting 

 from each particular combination of actions, became the stimulus to the invo- 

 luntary prolongation of that action. In some instances, it is possible that the 

 defect may result from malformation of the parts about the fauces, producing 

 an abnormal stimulus of this kind, in some particular positions of the organ ; 

 and such cases may be really benefited by an operation for the removal of 

 these parts. But the effect of the operation is evidently for the most part upon 

 the Nervous System ; and it coincides with what may be frequently observed, 

 that the Stammering is increased under any unusual excitement, especially 

 of the Emotional kind. 



619. The method proposed by Dr. Arnott for the prevention of Stammer- 

 ing, consists in the connection of all the words by a vocal intonation, in such 

 a manner, that there shall never be an entire stoppage of the breath. It is 

 justly remarked by Muller, however, that this plan may afford some benefit, 

 but cannot do everything; since the main impediment occurs in the middle of 

 words themselves. One important remedial means, on which too much stress 

 cannot be laid, is to study carefully the mechanism of the articulation of the 

 difficult letters, and to practise their pronunciation repeatedly, slowly, and 

 analytically. The patient would at first do well to practise sentences, from 

 which the explosive consonants are omitted; his chief difficulty, arising from 

 the spasmodic suspension of the expiratory movement, being thus avoided. 

 Having mastered these, he may pass on to others, in which the difficult letters 

 are sparingly introduced ; and may finally accustom himself to the use of 

 ordinary language. One of the chief points to be aimed at, is to make the 

 patient feel that he has command over his muscles of articulation ; and this 

 is the best done, by gradually leading him from that which he finds he can 

 do, to that which he fears he cannot. The fact that stammering people are 

 able to sing their words better than to speak them, has been usually explained 

 on the supposition that, in singing, the glottis is kept open, so that there is 

 less liability to spasmodic action; if, however, as here maintained, the spas- 

 modic action is not in the larynx, but in the velum palati and the muscles of 

 articulation, the difference must be due to the direction of the attention rather 



By Dr. Arnott this interruption is represented as taking place in the larynx ; that such is 

 not the case, the Author believes that a little attention to the ordinary phenomena of voice will 

 satisfactorily prove. 



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