940 OF THE VOICE AND SPEECH. 



prolongs the sound, by a full and exhausting expiration. In all these cases, 

 then, it seeins as if the muscular sense, resulting from each particular combi- 

 nation of actions, became the stimulus to the involuntary prolongation of that 

 action. It is possible that the defect may result, in some instances, from malfor- 

 mation 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 such 

 an operation is certainly exerted in most cases through the mind of the patient; 

 the expectation of benefit from it tending to improve his command over the 

 muscles of vocalization, which Emotional excitement always impairs; and the 

 improvement is usually proportional to the confidence which he has been led to 

 feel in the result. The slightest disturbance of the feelings is sufficient in 

 most Stammerers to induce a complete perturbation of the vocal powers ; the 

 very fear that stammering will occur, particularly under circumstances which 

 render it peculiarly annoying, is often sufficient to bring it on in a predisposed 

 subject; and the tendency to consensual imitation sometimes occasions stam- 

 mering in individuals (especially children) who never show the slightest tend- 

 ency to it except when they witness the difficulty in others. 



944. The method proposed by Dr. Arnott for the prevention of Stammering, 

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

 waanner, that there shall never be an entire stoppage of the breath. It is justly 

 remarked by Miiller, however, that this plan may afford some benefit, but can- 

 not 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 }>y 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 spasmodic 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 to the muscles of the larynx than to those of the mouth. 

 One of the most important objects to be aimed at in the treatment of stam- 

 mering, consists in the prevention of all Emotional disturbance in connection 

 with the act of Speech; and this requires the exercise of the Voluntary 

 power over the direction of the thoughts, in the following mode's : 1. To 

 reduce mental emotion, by a daily, hourly habit of abstracting the mind from 

 the subject of stammering, both while speaking and at other times. 2. To 

 avoid exciting mental emotion by attempting unnecessarily to read or speak 

 when the individual is conscious that he shall not be able to perform these actions 

 without great distress. 3. To elude mental emotion, by taking advantage of 

 any little artifice to escape from stammering, so long as the artifice continues to 

 be a successful one. Much may frequently be done, also, by constitutional 

 treatment, adapted to improve the general condition of the nervous system. 1 



1 See on the subject of "Stammering and its Treatment," a useful pamphlet under this 

 title, by Bacc. Med. Oxon., 1850; and Mr. Bishop's treatise "On Articulate Sounds, and 

 on the Causes and Cure of Impediments of Speech." 



