January 25, 19 12] 



NATURE 



407 



and, in addition, it may be hoped that the wish 

 expressed by the author will be fulfilled, and that the 

 book will be used as a text-book for students of 

 mathematics and physical science in the universities. 



W. H. W. 



The Real Cause of Stammering and its Permanent 

 Cure: a Treatise on Psycho-Analytical Lines. Bv 

 A. Appelt. Pp. ix + 234. (London: Methuen and 

 Co., Ltd., 191 1.) Price 35. 6d. net. 



MANY theories have been advanced to explain the 

 distressing complaint known as stammering, 

 and the modes of treatment have been equally 

 numerous. The treatment has often fallen into the 

 hands of quacks, who have pursued empirical methods 

 without any insight into the real nature of the afflic- 

 tion. The author of this book suffered during his 

 early youth and manhood; he put himself under the 

 care of specialists, and he was an inmate of three 

 institutions ; but the result was only failure and re- 

 lapse. He now considers himself to be completely 

 cured by a method entirely different from that usuallv 

 followed, and he gives the result of his investigations 

 and experience in this interesting volume. 



The subject is introduced by a concise historical 

 account of the notions that prevailed for centuries as 

 to the cause of stammering. The Jews, the Greeks, 

 and the Romans paid much attention to impediments 

 in speech, but it was not until the sixteenth century 

 that a real beginning was made by special observa- 

 tions by some of the early physicians. From that 

 time much has been written and many theories 

 have been advanced. The articulating mechanism 

 nas held to be at fault ; weakness of the soft palate ; 

 ioctive movements of the tongue; abnormal move- 

 nts of the larynx; spasm of the glottis, all received 

 I'lame. The discovery of reflex action, about 1841, 

 ' d to the view that stammering was due to a reflex 

 ;sm caused by excito-motor spinal action pre- 

 dominating over cerebral activity. Cerebral conges- 

 tion, spasms of the vessels in the brain, intense 

 lotional excitement, insuf!iciency and irregularity of 

 -piration, and abnormal nervous irritation were 

 (iuced as explanations. It is dreadful to realise 

 it some of these erroneous theories led to severe 

 rgical operations, such as cutting through the base 

 the tongue, and it was not until 185 1 that surgical 

 atment was abandoned as worse than useless. The 

 w that the impediment existed in the outer organs 

 ■speech was at last definitely abandoned, but it was 

 nly since the beginning of the present century that 

 investigators have come to the conclusion that stam- 

 ring is a psychical ailment, and that the special 

 use is a feeling of dread, "the dread of speaking," 

 and that to effect a cure the psychic influences or 

 'il)ulses must be met by counteracting suggestions. 

 The author gives a very interesting account of the 

 chanism of speech, not in the ordinary sense, but 

 the origin of the art of speaking in the child, 

 where have I read a better account of how babv 

 influenced in the production of vocal sounds bv 

 \0. 2204,, VOL. 88] 



: feelings of comfort or the reverse, of how he hears 

 I his own voice, and associates the sounds with those 

 i feelings; and so on, step by step, until the sounds 

 [ express ideas which are associated with baby himself, 

 j or with his parents, or those about him. There is 

 then a full account of the pathology of stammering. 

 j and it is shown how all the irregular movements are 

 I preceded by a feeling of dread. The stammerer dreads 

 j the effort, and the greater the dread the worse the 

 stammering, until, in extreme cases, there is positive 

 mental torture, which reacts on the psychological con- 

 I dition of the sufferer, and may even alter his char- 

 i acter. It is remarkable that there is no spasm of the 

 I glottis: "the closure of the glottis ceases instan- 

 taneously when the stammerer gives up his intention 

 to speak." In this otherwise excellent description the 

 author uses the word "anelectrotonus," but as this 

 word has a very definite meaning in electro-physiology, 

 it would be better to avoid its use as applied to the 

 phenomena described by the author. The author also 

 often describes affections of " nerves " when he 

 evidently means " nerve centres." Nerves are con- 

 ductors; the intimate phenomena of nervous action 

 take place in the collocations of nervous matter we call 

 "centres," although it must be confessed we know 

 very little about the phenomena occurring therein. 



The author then comes to the essence of his thoor\ , 

 namely, that stammering is essentially a psychic dis- 

 turbance. At the root of speech lie the emotions ; iht 

 results of emotional states may remain long in a 

 hidden condition, or are awakened only now and then. 

 Such emotional conditions may be repressed, and 

 from the days of infancy they are habitually repressed. 

 Thus we may consider them to be in a state of tension, 

 and this tension may disturb the centres for speech, 

 if it is associated with feelings of dread. These feel- 

 ings of dread may have first originated in childhood, 

 and for years they may exist in the mind uncon- 

 sciously. The author holds strongly the modern view 

 of unconscious mental .operations that develop into 

 a second, and usually hidden, self. This implies that 

 there may be mental operations without consciousness. 

 With this modern view I cannot agree. It is not 

 necessary for me, however, to state my objections 

 here, but rather to give a fair account of the author's 

 vi< \v, which he regards as the kernel of hi- 

 theory. This unconscious mind is a psychic complex 

 endowed with extremely intense emotions and inhibi- 

 tions. The individual is under its influence, and "the 

 physical and psychic symptoms of defective speech are 

 merely projections of the conflicts piled up in the 

 emotional complex." The unconscious psychic com- 

 plex is often in conflict with the conscious ego, and 

 a feeling of dread, of dread of the unknown and 

 mysterious, more than simply a feeling of fear, ori^- 

 cedes the articulatory disorder. 



This psychological view leads to a rational 

 therapeutics. Abandon exercises in elocution ; 

 "•ive up the dreaded pronunciation of certain 

 words; try the effect of auto-suggestions, such 

 as "I shall get over this and soon be quite 

 well"; submit to hetero-suggestions of the same kind 

 originating in the teacher or trainer, in whom the 



