PATHOLOGICAL VARIATIONS OF VOICE AND SPEECH. 523 



tion, and hysteria, or by serous effusions into the laryngeal muscles. If the tensors are paralysed, 

 monotonia is the chief result : the disturbances of respiration in paralysis of the larynx are 

 important. As long as the respiration is tranquil, there may be no disturbance, but as soon as 

 increased respiration occurs, great dyspnoea sets in, owing to the inability of the glottis to 

 dilate. 



If only one vocal cord is paralysed, the voice becomes impure and falsetto-like, while we may 

 feel from without that there is less vibration on the paralysed side (Gerhardt). Sometimes 

 the vocal cords are only so far paralysed that they do not move during phonation, but do so 

 during forced respiration and during coughing (phonetic paralysis). 



Diphthongia. Incomplete unilateral paralysis of the recurrent nerve is sometimes followed 

 by a double tone, owing to the unequal tension of the two vocal cords. According to Tiirck 

 and Schnitzler, however, the double tone occurs when the two vocal cords touch at some part 

 of their course (e.g., from the presence of a tumour, fig. 367), so that the glottis is divided into 

 two unequal portions, each of which produces its own sound. 



Hoarseness is caused by mucus upon the vocal cords, by roughness, swelling, or laxness of 

 the cords. If, while speaking, the cords are approximated, and suddenly touch each other, 

 the "speech is broken," owing to the formation of nodal 

 points ( 352). Disease of the pharynx, naso-pharyngeal 

 cavity, and uvula may produce a change in the voice reflexly. 



Paralysis of the soft palate (as well as congenital per- 

 foration or cleft palate) causes a nasal timbre of all vowels ; 

 the former renders difficult the normal formation of con- 

 sonants of the third articulation position ; resonance is 

 imperfect, while the explosives are weak, owing to the escape 

 of the air through the nose. 



Paralysis of the tongue weakens I ; E and A (M) are less 

 easily pronounced, while the formation of consonants of the 

 second and third articulation position is affected. The term Fig. 367. 



aphthongia is applied to a condition in which every attempt Tumours on the vocal cords causing 

 to speak is followed by spasmodic movements of the tongue double tone from the larynXt 

 {Fleury). J 



In paralysis of the lips (facial nerve), and in hare-lip, regard must be had to the formation 

 of consonants of the first articulation position. When the nose is closed, the speech has a 

 characteristic sound. The normal formation of resonants is of course at an end. After excision 

 of the larynx, a metal reed, enclosed in a tube, and acting like an artificial larynx, is introduced 

 between the trachea and the cavity of the mouth (Czerny). 



Stammering is a disturbance of the formation of sounds. [Stammering is due to long-con- 

 tinued spasmodic contraction of the diaphragm, just as hiccough is ( 120), and, therefore, it is 

 essentially a spasmodic inspiration. As speech depends upon the expiratory blast, the spasm 

 prevents expiration. It may be brought about by mental excitement or emotional conditions. 

 Hence, the treatment of stammering is to regulate the respirations. In stuttering, which is 

 defective speech due to inability to form the proper sounds, the breathing is normal.] 



320. COMPARATIVE HISTOKICAL. Speech may be classified with the "expression of 

 the emotions" (Darivin). Psychical excitement causes in man characteristic movements, in 

 which certain groups of muscles are always concerned, e.g., laughing, weeping, the facial ex- 

 pression in anger, pain, shame, &c. These movements afford a means whereby one creature can 

 communicate with another. Primarily in their origin, the movements of expression are reflex 

 motor phenomena ; when they are produced for purposes of explanation, they are voluntary 

 imitations of this reflex. Besides the emotional movements, impressions upon the sense-organs 

 produce characteristic reflex movements, which may be used for purposes of expression (Geiger), 

 e.g., stroking or painful stimulation of the skin, movements after smelling pleasant or unpleasant 

 or disagreeable odours, the action of sound and light, and the perception of all kinds of objects. 



The expression of the emotions occurs in its simplest form in what is known as expression by 

 means of signs or pantomime or mimicry. Another means is the imitation of sounds by the 

 organ of speech, constituting onamatopoesy, e.g., the hissing of a stream, the roll of thunder, 

 the tumult of a storm, whistling, &c. The expression of speech is, of course, dependent upon 

 the process of ideation and perception. 



The occurrence of different sounds in different languages is very interesting. Some languages 

 (e.g., of the Hurons) have no labials; in some South Sea Islands, no laryngeal sounds are 

 spoken ; / is absent in Sanscrit and Finnish ; the short e, 0, and the soft sibilants in Sanscrit ; 

 d, in Chinese and Mexican ; s, in many Polynesian languages ; r, in Chinese, &c. 



Voice in Animals. Animals, more especially the higher forms, can express their emotions 

 by facial and other gestures. The vocal organs of mammals are essentially the same as those 

 of man. Special resonance organs occur in the orang-outang, mandril, macacus, and mycetes 

 monkeys, in the form of large cheek pouches, which can be inflated with air, and open between 

 the larynx and the hyoid bone. 



