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STAMMERING AND COGNATE 
 DEFECTS OF SPEECH 
 
STAMMERING 
 
 AND COGNATE DEFECTS 
 
 OF SPEECH 
 
 f ri.iM' 
 
 BY 
 C. S. BLUEMEL 
 
 VOLUME I 
 THE PSYCHOLOGY OF STAMMERING 
 
 NEW YORK 
 G. E. STECHERT AND COMPANY 
 
 LONDON — LEIPZIG — PARIS 
 
Copyright, 1913, 
 By C. S. BLUEMEL. 
 
 All rights reserved. 
 
 "^^ r 4- 9 4, 
 
 J. B. Gushing Co. — Berwick <fc Smith Co. 
 Norwood, Mass., U.S.A. 
 
PREFACE 
 
 Five years ago the author began a systematic in- 
 vestigation into the cause of stammering. In his 
 preliminary notes he wrote as follows : 
 
 " The true theory of causality must explain all the facts. It 
 must explain the fact — 
 
 " That the stammerer can usually sing without difficulty. 
 
 "That the stammerer can often speak well when alone. 
 
 " That the stammerer is usually fluent when speaking in con- 
 cert with other people. 
 
 "That the stammerer can usually repeat fluently the words 
 that are pronounced for him by another person by way of 
 assistance. 
 
 " That the stammerer can usually repeat a word that he has 
 eventually stammered out. 
 
 " That consonants followed by short vowels are more difficult 
 for the stammerer than consonants followed by long vowels. 
 
 " That consonants at the end of a word never occasion diffi- 
 culty. 
 
 " That the stammerer may have difficulty on words that com- 
 mence with vowels. 
 
 "That the speech-defect may assume the most diverse forms, 
 being in one case passive, and in another active and boister- 
 ous." 
 
 "That one can stammer in thought as well as in speech. 
 
 "That there are more male than female stammerers. 
 
 " That stammering is rarely acquired after the fifteenth year." 
 Etc., etc. 
 
 The theory of causality that the author has arrived 
 at affords what appears to be a satisfactory explana- 
 tion of the various paradoxes mentioned. The theory 
 has been developed in large part as the result of in- 
 
vi PREFACE 
 
 trospective evidence, — evidence as indispensable as 
 it was uncoveted. 
 
 The theoretical discussion of the causality and 
 psychology of stammering is presented in the first 
 volume of this book. 
 
 In the second volume the author has reviewed and 
 criticised the systems at present employed in treating 
 stammering in Europe and America. He has thus 
 fulfilled, at a somewhat late date, the wish that Schul- 
 thess and some of his contemporaries expressed nearly 
 a century ago — that some one would embody in a 
 single volume all known systems applicable to the treat- 
 ment of stammering. But lest the words " all known 
 systems" should imply too much, let the author add 
 that he does not profess to be omniscient ; and, fur- 
 ther, that the systems that he has reviewed are merely 
 those that he knows to be current or to have been 
 recently current in the therapy of stammering. The 
 author has made no attempt to undertake an his- 
 torical review, since this field has been effectively 
 covered by Hunt in his " Stammering and Stutter- 
 ing." The contemporaneous systems given repre- 
 sent, however, the principal methods of the United 
 States of America, Canada, the British Isles, France, 
 Switzerland, Germany, Belgium, Holland, Denmark, 
 Scandinavia, Russia, and Austria. These systems 
 are therefore thoroughly representative of those em- 
 ployed in the civilized world. 
 
 The systems cited in this review have not, as a 
 
PREFACE vii 
 
 rule, been given for their sovereign merit. Indeed, 
 many of the systems are entirely devoid of merit; 
 they have been recorded merely because they are the 
 gold bricks that are daily sold to stammerers by an 
 infamous fraternity of '* speech specialists." These 
 wretched systems — and, indeed, most elocutionary 
 systems — must inevitably become obsolete with the 
 advancement of the psychological investigation of 
 stammering. But meanwhile progress is hampered 
 by charlatans, who rob the stammerer and bring 
 everybody and everything connected with the treat- 
 ment or investigation of stammering into disrepute. 
 Manifestly it is incumbent upon stammerers them- 
 selves to remedy these conditions. 
 
 A glossary has been appended to the second vol- 
 ume of the book. This has been made sufficiently 
 comprehensive to render the book available to the 
 youthful stammerer. 
 
 The author is indebted to Professor V. A. C. Hen- 
 mon (of the Department of Psychology at the Uni- 
 versity of Wisconsin) and to Professor Lawrence W. 
 Cole (of the Department of Psychology at the Uni- 
 versity of Colorado) for valuable criticisms of the first 
 volume of this monograph. The author is also in- 
 debted to the numerous friends that have in various 
 ways and at various times assisted him in the prep- 
 aration of the work. 
 
 C. S. B. 
 
 Boulder, Colorado, 
 October, 1912. 
 
TABLE OF CONTENTS 
 
 CHAPTER I 
 
 PAGE 
 
 Introduction . . i 
 
 CHAPTER n 
 Mental Types : Eye-mind edness, Ear-mindedness, etc. 25 
 
 CHAPTER HI 
 The Verbal Image 40 
 
 CHAPTER IV 
 The Brain 61 
 
 CHAPTER V 
 
 The Relation between Mental Imagery and Vol- 
 untary Speech 86 
 
 CHAPTER VI 
 Impairment of the Brain-centres: Aphasia . . 106 
 
 CHAPTER VII 
 
 Stammering , 181 
 
 ix 
 
X TABLE OF CONTENTS 
 
 CHAPTER VIII 
 
 PAGE 
 
 Mental Confusion in Stammering .... 279 
 
 CHAPTER IX 
 Fear and Auto-suggestion 291 
 
 CHAPTER X 
 Corollaries . 334 
 
THE PSYCHOLOGY OF 
 STAMMERING 
 
 CHAPTER I 
 
 INTRODUCTION 
 
 Stammering and cognate defects of speech have in 
 the past been studied almost exclusively in their 
 physical manifestations. The point of view has been 
 that of physiology. In the present work the subject 
 will be considered primarily in its mental aspect. 
 The point of view will be that of psychology. For 
 this reason it will be necessary at the outset to con- 
 sider a few of the fundamental principles of psychology 
 itself, and the meanings of the psychological terms that 
 will occur most frequently in this monograph.^ 
 
 Psychology 
 
 Psychology is commonly defined as the science of 
 mental life, or the science of consciousness. It is the 
 study of the mental processes, — of their nature and 
 function. 
 
 ^ A complete glossary is also given at the end of the second volume. 
 
 I 
 
2 THE PSYCHOLOGY OF STAMMERmG 
 
 Sensation 
 
 By sensation, the psychologist means the conscious- 
 ness arising from the stimulation of one of the bodily 
 sense-organs. One has sensations of sight as ether- 
 waves impinge upon the retina of the eye ; sensations 
 of sound as air- vibrations strike the drum of the ear ; 
 sensations of smell when free particles of matter, 
 floating in the atmosphere, stimulate the olfactory 
 nerves ; and so on. 
 
 The senses were formerly considered to be five in 
 number, — sight, hearing, feeHng, taste, and smell. 
 To-day the number of senses recognized by the psy- 
 chologist is in the neighborhood of eighteen. Each 
 is regarded as an elementary sense with special end- 
 organs conveying the sensory current to the brain. 
 **FeeKng" (or touch) is differentiated into elementary 
 sensations of pressure, pain, warmth, and cold. 
 Closely alHed to this group are the kinaesthetic sensa- 
 tions, — sensations involved during muscular activity. 
 The kinaesthetic sensations are conveyed to the brain 
 by sensory nerves found in the muscles, tendons, and 
 joints. These sensations are felt in the arm as one 
 lifts a heavy weight ; they are felt chiefly in the fingers 
 and forearm as one clenches the fist ; they are detected 
 in the lips and tongue during speech. The organic 
 sensations may be included as further subdivisions of 
 **feehng." They are sensations from within the body 
 
INTRODUCTION 3 
 
 itself, — feelings of hunger, thirst, and nausea, and 
 sensations from the respiratory and circulatory sys- 
 tems. (These sensations are distinctly emotional in 
 their coloring. They will be considered in their rela- 
 tion to the emotions in Chapter IX.) The static sen- 
 sations report the movements of the body as a whole. 
 A sensation is sometimes spoken of as an impression. 
 
 Mental Images 
 
 Sensations arise as the result of the actual stimula- 
 tion of the sense-organs. They may, however, be re- 
 vived in memory quite independently of the stimulus, 
 in which case they are known as mental images. Men- 
 tal images are often dim and fugitive, but in dreams 
 and hallucinations they are sufficiently intense to be 
 mistaken for actual sensations. During the waking 
 state the sensations that one experiences are usually 
 too vivid to allow mental images to come conspicu- 
 ously to the foreground of consciousness. However, 
 as one is sitting in perfect quietness in the dark, 
 mental images frequently present themselves with 
 considerable clearness. In revery one reviews old 
 scenes and scans the faces of absent friends; one 
 hears absent voices, and enjoys music that comes 
 back in thought. 
 
 These mental images are not restricted to any 
 particular field of sensation ; they may represent any 
 sensation that has occurred in consciousness. They 
 
4 THE PSYCHOLOGY OF STAMMERING 
 
 are not the mere habitants of dreams, nor is there 
 anything poetic or fantastic in their nature. They 
 are the material with which we think ; and they are 
 just as indispensable for the solution of a problem in 
 geometry as they are for the production of an artist's 
 masterpiece. 
 
 The visual image is easily recognized if one glances 
 at some object — a picture, for example — and im- 
 mediately closes the eyes. There is no definite point 
 in time at which the sensation can be said to vanish ; 
 certainly it does not terminate with the closing of the 
 eyes. For a moment the mental picture is present 
 v^ith vivid color and accurate detail. One can examine 
 it for points that escaped observation during actual 
 vision. Strictly speaking, this mental picture is an 
 after-sensation. It is called the primary mental 
 image, in contradistinction to the secondary imagCy 
 — the re-called image, or memory-image proper.^ 
 
 Memory-images differ from sensations mainly in 
 the fact that they are usually less distinct. These 
 secondary visual images are present in the mind as 
 one recalls any visual experience, — as one sketches 
 a scene from memory, for instance. Artists frequently 
 have so vivid a memory for visual impressions that 
 
 1 The visual after-image is often a negative image ; i.e. there is 
 an inversion of light and shade, as in the photographic negative. 
 In the negative after-image the spectral colors are replaced by their 
 complementary colors. 
 
INTRODUCTION 5 
 
 they are able to paint, with the greatest accuracy of 
 detail and color, scenes that they have not beheld 
 for years. 
 
 Visual images are usually clearest the first moment 
 they arise in consciousness. As a rule, they do not 
 become clearer with mental fixation. In this respect 
 the visual image might be compared to the visual 
 impression that one gets from the sun, or a brilHant 
 light flashing out in the darkness. For an instant 
 the vision is distinct, but it melts in a moment to 
 a shapeless blur. In many cases the analogy will 
 not hold. Some people can scrutinize their visual 
 images at will ; with others the image is not clear even 
 at the moment of its first appearance in consciousness. 
 Under abnormal conditions the mental image may 
 assume the vividness of an actual sensation. In 
 this case there is usually an ''hallucination." The 
 condition is pathological, and does not frequently 
 occur. To it may be attributed many of the super- 
 natural phenomena that excite the wonder of the 
 credulous. It is safe to say that no self-respecting 
 ghost would haunt anything but a mind affected by 
 a disordered liver. Frequently the subject of such 
 an experience is fully aware of the hallucinatory 
 character of the sights that he sees or the sounds that 
 he hears. In this case he is said to experience a 
 *' pseudo-hallucination." 
 
 Auditory images are present in one's memory of 
 
6 THE PSYCHOLOGY OF STAMMERING 
 
 sounds. One listens to ''ear-haunting" tunes. A 
 person picks up a musical score; and, as he reads 
 the notes, hears the tune in mental imagery. A 
 musician may compose music in a train, jotting down 
 the notes as the strains of music rise in his mind. 
 One may Hsten in memory to the commoner physical 
 sounds, hearing in auditory images the rumble of 
 a wagon in the street or the clop-clop of horses' hoofs. 
 After a tedious train journey many people hear for 
 hours the clangor and rumble of the train.^ 
 
 In audition, again, we have the primary mental 
 image, — occurring in the form of a mental "echo." 
 The primary memory is often conspicuous where the 
 secondary memory for sounds is deficient. 
 
 Tactual images (or touch memories) are often quite 
 clear when they reflect distinctive sensations. One 
 ''feels" the soft, cold petals of a rose as it is (ip imagi- 
 nation) touched to the Hps. One can recall the cold, 
 smooth feeHng of marble or the soft feeling of velvet, 
 and mentally contrast these feeHngs with the rough 
 feeling of sandpaper. One can imagine the sensation 
 that would result from plunging the hands into hot 
 water, or the freezing chill one would experience on 
 falHng through the ice. (These last two are, strictly 
 speaking, thermal images.) One may have images 
 
 * People differ greatly in their capacity for recalling the experi- 
 ences of the different senses. This point will be considered in Chap- 
 ter n in the discussion of mental types. 
 
INTRODUCTION 7 
 
 of pain whilst listening to the vivid description of 
 an accident ; and one may imagine the pain of running 
 broken glass into the fingers or cutting the fingers with 
 a knife. 
 
 Gustatory images arise in the mind as one hstens to 
 the description of a feast. The writer recently read 
 an account of an antarctic expedition in which the 
 explorers, when their pemmican was low, would 
 amuse themselves for hours by describing by turns the 
 sumptuous feasts they would enjoy upon their return 
 to civilization. After the descriptions they would 
 vote upon the menus. There was roast turkey, 
 steaming-hot plum pudding, and numberless other 
 things that would appeal to starving men. The 
 pleasure of the pastime was, of course, in the play of 
 the gustatory imagery. 
 
 Olfactory images are often present in the stream of 
 consciousness. One may recall in mental imagery 
 the smell of burning tobacco, of cooking bacon, the 
 odor of a rose, of cheese, of garHc, and of numerous 
 other objects that have occasioned olfactory sensa- 
 tions. 
 
 KincBsthetic, or motor, images will occupy a posi- 
 tion of prominence in later discussions. They are 
 the memories of muscular movements, — memories 
 of the muscular feelings involved in clenching the 
 fist, in flexing or extending the arm ; they are images 
 of the movements made in writing, in playing the 
 
8 THE PSYCHOLOGY OF STAMMERING 
 
 piano, and in speaking ; they are, in fact, the remem- 
 bered feelings of any muscular movement whatever. 
 People that have lost an arm can often mentally 
 move the lost hand and work the missing fingers. 
 These movements occur, of course, in kinaesthetic 
 imagery. 
 
 Mental images are representative of past sensa- 
 tions. It is quite impossible for one to imagine a 
 sensation that has not been experienced. A man that 
 is born bhnd can never imagine the sensations of 
 sight. A man that has not looked at the moon 
 through a telescope cannot imagine what the ap- 
 pearance of the moon would be. A man that has 
 never heard an Indian tom-tom can have no auditory 
 image that represents the sound. A man that is 
 born deaf has no auditory imagery whatever. Not 
 only is he unable to imagine sounds, but he is totally 
 unable to imagine what sound is like. A person that 
 is born deaf remains dumb because he has never 
 heard words, and is consequently unable to call up 
 word-images in his mind.^ 
 
 Mental images may, however, be recombined so 
 that the collocation is original. One can imagine 
 a winged horse, without having seen such a beast. 
 But both the horse and the wings have occurred 
 separately in experience. One pictures to himself 
 * This last statement will be modified later. See pp. 46 ff. and p. 95. 
 
INTRODUCTION 9 
 
 a purple moon, — a thing apparently original. Yet 
 he has formerly seen the moon and experienced the 
 color purple. He has merely recombined elements 
 of his past experience. In the last analysis, the ele- 
 ments of any combination of mental imagery will 
 be found to be reproductions of one's former sensations. 
 
 Imagination is called productive, or constructive, 
 when it involves an original collocation of mental 
 images. It is termed reproductive when it involves 
 a mere reproduction of sensations — in the arrange- 
 ment in which they occurred. Reproductive im- 
 agination is thus practically identical with memory. 
 However, the mere duplication of sensations in mental 
 imagery is not memory. There is necessary, in addi- 
 tion, the knowledge of the fact that the mental images 
 portray former experiences. 
 
 A mental image is sometimes referred to as an idea. 
 Strictly speaking, it is an idea only when it is con- 
 sidered in relation to its meaning. 
 
 Association 
 
 The association of ideas in the mind is due largely 
 to previous experience. If two sensations have 
 occurred together, the mental image of the one is 
 likely to redintegrate, or recall, the mental image of 
 the other. The phenomenon is due to mental or 
 neural habit. The tunes of the English and German 
 national anthems and the American national song, 
 
lo THE PSYCHOLOGY OF STAMMERING 
 
 "America," are identical. When the German hears 
 this particular air, he immediately thinks of the 
 words ''Heil Dir im Siegerkranz " ; the American, 
 on hearing the melody, associates it with the words 
 "My Country, 'tis of Thee"; and the Englishman 
 associates the same tune with " God save our Gracious 
 King." In each case the associations are due solely 
 to experience : the words and the tune have occurred 
 together in the past. Again, one picks up a volume 
 of Milton, and in a few seconds inquires the name of 
 the last Emperor of China. What is the connection ? 
 The book suggested printing ; China was thought of 
 as the home of printing; the interest then turns to 
 the country's poHtical affairs, and prompts the ques- 
 tion concerning the emperor. The associations are 
 due to contiguity. 
 
 Ideas thus suggest one another when the experiences 
 that they represent have been contiguous either in 
 time or in space. In passing a certain house one is 
 reminded of the people that Hve there. The associa- 
 tion is one of spatial contiguity. Similarly, an orange 
 reminds the town-bred man of a fruiterer's shop; 
 while it reminds the orange-grower of his orange 
 groves. In each case the associations are due to the 
 fact that the objects thought of have been adjacent 
 in space. By temporal contiguity an orange-grove 
 may remind one of a toothache for the reason that 
 he was suffering from toothache at a time when he 
 
INTRODUCTION ii 
 
 visited an orange-grove. Again, the sound of a 
 particular melody may recall the place where it was 
 heard. In these cases the association is one of tem- 
 poral contiguity. 
 
 For two objects to be associated in space they must 
 of course appeal to sight or touch. But when objects 
 are seen or felt together, they must be seen or felt 
 simultaneously; therefore spatial association always 
 involves temporal association. On the other hand, 
 when two experiences are associated only in time, 
 one or both must appeal to a non-spatial sense — 
 such as hearing, smell, or taste, for instance; hence 
 normal temporal association excludes spatial associa- 
 tion.^ It follows that there is a double connection 
 between things seen or felt together, and but a single 
 connection between conjoined experience of the other 
 senses. 
 
 When sensations follow one another, the associa- 
 tion is always stronger in the order of the occurrence. 
 After learning the alphabet forwards, one cannot im- 
 mediately say it backwards. 
 
 The associations in the minds of lower animals are 
 almost exclusively those of contiguity. The stage- 
 feats of so-called performing animals are explained 
 by the associations of certain bodily movements with 
 
 ^ Sounds and odors can, of course, be thought of as coming from 
 a particular point in space; but in this case the spatial relation is 
 expressed in the mind in terms of sight or touch. 
 
12 THE PSYCHOLOGY OF STAMMERING 
 
 signals given from behind the scenes. The perform- 
 ing horse stamps his hoof as the attendant in the wings 
 waves a flag. He responds merely as an automaton, 
 and it is needless to say that he knows nothing of 
 the questions that he is credited with answering. 
 
 There is a distinctive form of association that 
 sunders the human mind from that of the brute; it 
 is association hy similarity. When the round stone 
 suggests a hammer and the sharp stone an axe, 
 when a springing branch suggests a bow and the fall- 
 ing of an apple suggests the mutual attraction of 
 bodies ; then the human mind supersedes experience. 
 When a person's associations are those of contiguity, 
 he must inevitably be a clumsy and laborious thinker. 
 He plods along, thinking in mental brickbats, and 
 erecting his thought-structures piece by piece. The 
 person associating things by similarity holds, as it 
 were, the magic wand of thought. A bare suggestion, 
 and the whole superstructure of thought stands 
 complete : the process seems sufficiently thaumatur- 
 gic to transcend the laws of association. 
 
 Genius, it is held by some psychologists, is identical 
 with the possession of "similar" association to an 
 extreme degree. This faculty is accounted suflicient 
 to explain the achievements of the Newtons and the 
 Darwins.^ 
 
 1 There is considerable difiference, however, between obeying 
 similarity and detecting it. Genius is rather the faculty for detect- 
 
INTRODUCTION 13 
 
 Contrast, as a cause of association, is but another 
 phase of similarity. Cause and effect is reducible 
 to contiguity. 
 
 It is beyond question that we are no more able to 
 ignore association in our thinking than we are able 
 with our mental images to transcend experience. 
 One idea is not able to redintegrate any other idea 
 that we mav wish. The ideas that it recalls must 
 be associated by contiguity or similarity. At best 
 we can seize upon one of several ideas that present 
 themselves. Associations do appear that seemingly 
 violate all these relations ; yet the associations un- 
 doubtedly occur in the fringe of consciousness. There 
 are in our minds rudimentary and fugitive thoughts 
 that do not come to the focus of attention. Writing 
 on obscure associations, James says : ^ ''If I hear a 
 friend describe a certain family as having blotting-paper 
 voices, the image, though immediately felt to be 
 appropriate, bafHes the utmost powers of analysis." 
 The relation here appears to be hidden in the shadows 
 of the mind. If one could admit similarity between 
 the experiences of disparate senses, he would probably 
 
 ing it. (See James, "Principles of Psychology," Vol. II, p. 361.) 
 Efficiency in abstract thought is perhaps due to the ability to attach 
 the maximum of meaning to a minimum of imagery. The question 
 then arises as to the nature of meaning, and it may be found that 
 meaning is as much dependent upon contiguous association as upon 
 similar association. 
 
 1 "Principles of Psychology," Vol. I, p. 582. 
 
14 THE PSYCHOLOGY OF STAMMERING 
 
 seek a resemblance between the characteristic quality 
 of the voices and the soft feeHng of blotting-paper. 
 It seems difficult, however, to beheve that there can 
 be similarity between the experiences of unrelated 
 senses. It may perhaps be that the resemblance lies 
 between the sound that results from tearing blotting- 
 paper, and the sound of the thick and somewhat 
 husky voices to which the paper is compared. The 
 association would then be complex, involving both 
 similarity and temporal contiguity. Many such 
 associations occur that, for the time being, defy 
 analysis. Frequently it is only by chance that one 
 stumbles upon the explanation. There can be little 
 doubt, however, that a relation of contiguity or simi- 
 larity invariably exists. 
 
 Perception 
 
 Perception is the mental process by which the mind 
 associates sensations with mental images. The bare 
 sensation is not an element of knowledge. It is a 
 mere ''that." The percept is a ''that which." It is 
 the sensation, plus its associated images. Bare 
 sensations, then, do not frequently occur in adult life. 
 As one inhales the fragrance of a rose, attending merely 
 to the odor, he experiences something akin to the pure 
 sensation. But generally things are regarded for 
 their meaning. One hears a rumble in the distance, 
 and "perceives" a train. The rumble, however, is 
 
INTRODUCTION 15 
 
 a mere auditory sensation. The idea of the train arises 
 by virtue of association, the sound suggesting the 
 train's appearance and other quahties. The reader 
 sees printed words on the page before him. The words 
 are so many black marks upon a white background. 
 They have meaning only because they are associated 
 with certain sounds, — the spoken words they rep- 
 resent. The spoken words, in their turn, are purely 
 arbitrary symbols. Frequently they have different 
 meanings in different languages.^ The meaning is 
 determined entirely by the object, action, etc., that 
 the word recalls. 
 
 The mind in reahty contributes the greater part 
 of the percept. The bare sensation resulting from 
 the stimulation of the peripheric sense-organ is nothing 
 more than a cue. As a unitary thing it is devoid of 
 meaning. The multitudinous associations alone con- 
 fer meaning upon it. One sees a table top as a square, 
 though the retinal image is that of a rhombus. A 
 figure in the distance is perceived as a man, though 
 one can ''cover" him with the little finger. A boy, 
 a Httle nearer, produces a retinal image ten times as 
 large ; yet the boy is not mistaken for a giant. It 
 is the mind's contributions, the associations, that 
 prevent utter chaos in the interpretation of impres- 
 
 ^"The Chilians say papa for 'mother/ and the Georgians say 
 mama for 'father,' while in various languages dada may mean 'father,' 
 'cousin,' 'nurse'; lata, 'father,' 'son,' 'good-bye! '" (Tylor, "Anthro- 
 pology," p. 129.) 
 
i6 THE PSYCHOLOGY OF STAMMERING 
 
 sions. Common illusions are due to the mind's 
 contributing the wrong images to a "misinterpreted" 
 cue. One hears the rustle of leaves, and mistakes 
 the sound for approaching footsteps; or, seeing a 
 shadow on the wall, one ''perceives" a ghost. The 
 illusion is due to the fact that an inappropriate image 
 advances to meet the sensation. 
 
 Conception 
 
 A concept is a congeries of associated mental images. 
 The act of the mind in regarding the relation between 
 these images, or the relation between different con- 
 cepts, is called conception. The concept of an apple 
 may be regarded as the following group of associated 
 mental images : the visual image of its appearance, 
 the image of its taste, the image of its smell, the image 
 derived from handling it, and the verbal image of its 
 name. There might be still other images, more or 
 less nascent, — the memory of the sound produced 
 by paring an apple, and a kinaesthetic image of the 
 biting action of the jaw, for instance. One particular 
 image usually forms the nucleus of the concept. In 
 the present case it would most likely be the visual 
 image of the fruit, or the verbal image of the word 
 ''apple." The images associated with the nucleus do 
 not usually come to the foreground of consciousness. 
 Some of the images may be entirely lacking. A person 
 bom blind would have no visual images in his con- 
 
INTRODUCTION 17 
 
 cepts ; a congenitally deaf man would have no images 
 of sound. 
 
 When the concept is of an abstract nature, the 
 nucleus is usually a verbal image. The nucleus of 
 a concept used in communication is almost invariably 
 an arbitrary symbol of this kind, — a spoken or 
 written word, a word spelled out in the manual 
 alphabet or in telegraphic code. However, the 
 symbol contains no innate meaning ; its import is 
 derived solely from the mental images with which 
 it is associated. 
 
 Cognition, Affection, and Volition 
 
 The mental .processes are sometimes classified under 
 the three headings. Cognition, Afection, and Volition; 
 in other words, knowing, feeling, and willing. 
 
 The cognitive processes are those that convey the 
 elements of knowledge. Such, for instance, are 
 Sensation, Perception, Conception, Judgment, and 
 Reasoning. (Judgment and Reasoning are merely 
 more complex processes of conception and association.) 
 Affection is the emotional coloring of the cognitive 
 states. It is the pleasantness or unpleasantness of 
 a particular experience, — the pleasantness in the 
 odor of a rose, the unpleasantness in a toothache. 
 As AngelP puts it, cognition gives the "what"; 
 affection gives the "how." Cognition and affection 
 
 1 "Psychology," p. 302. 
 
i8 THE PSYCHOLOGY OF STAMMEREnTG 
 
 are merely different aspects of the same mental 
 states.^ 
 
 For the present discussion the will may be regarded 
 subjectively as the decision to act. Objectively, it 
 is the biological property of ''irritabiHty" ; ix. the 
 tendency of all living matter to express a sensory 
 stimulus in a motor response.^ The subject will be 
 considered a little more fully in a later chapter. 
 
 The Nature of Thought 
 
 Words are by no means essential to thought. The 
 whole breadth of the stream of consciousness may 
 be engaged by a series of sensations and perceptions. 
 One may walk through the country, drinking in the 
 sights and sounds, with never a verbal thought in 
 one's mind. For conception, too, one may dispense 
 with words entirely. In playing chess, solving prob- 
 lems in geometry, designing bridges and machinery, 
 visual images alone are necessary. In composing 
 music, auditory images suffice ; verbal images would 
 be an encumbrance. 
 
 Meeting a person in the street, one may think to 
 himself, ^'I wonder if that man is the actor I saw per- 
 forming last evening; " yet not a single word need be 
 contained in the idea. The visual impression arouses 
 
 ^ As will be explained in Chapter IX, the emotions are, in their 
 last analysis, organic sensations in which affection is at a maximum 
 and cognition at a minimujn. 
 
 2 This is the law of dynamo genesis. 
 
INTRODUCTION 19 
 
 the image of the actor as he was seen upon the stage, 
 and the relationship of identity presents itself to the 
 mind in some recondite manner that is no less in- 
 scrutable than consciousness itself. Again, the visual 
 imagery may "reply," "No, this man is too tall, and 
 too stout." No words would be necessary unless 
 the thought were to be communicated to another 
 person. In this case the words would not be under- 
 stood unless — as purely arbitrary symbols — they 
 aroused the appropriate visual images in the mind 
 of the auditor. The whole thought-process might 
 well occur in the mind of a deaf and dumb man that 
 had never heard or spoken a word in the course of his 
 existence. The thought may, of course, be accom- 
 panied or followed by verbal images, but in this case 
 the words are visually initiated, just as they are visu- 
 ally interpreted by the person that hears them 
 spoken. 
 
 To take another instance : — A man stands upon 
 the doorstep surveying the sky; then decides to 
 reenter the house for his umbrella. The thought- 
 process is probably as follows: The black clouds 
 conjure up in the man's mind visual images of falling 
 rain (or he may have tactual images of raindrops 
 striking his cheeks). He then visualizes himself 
 in the act of holding up an umbrella. This image im- 
 mediately redintegrates another visual image of the 
 umbrella standing in a particular part of the house, 
 
20 THE PSYCHOLOGY OF STAMMERING 
 
 and he thereupon decides to fetch it.^ There might 
 arise in his mind the words, "I must get my umbrella " ; 
 but if they appear, they do so after the decision to act, 
 — that is, when the thought-process is complete. 
 The words have no intrinsic part in the thought; 
 they are purely epiphenomenal. If, by sheer asso- 
 ciation, the clouds could arouse the verbal thought, 
 '^It is going to rain," the words would still mean 
 nothing without their visual associates. If this 
 thought were followed by the words, ^'I must get my 
 umbrella," the man would still be no farther forward 
 if there were lacking concrete images of his umbrella 
 and the place where it stood. He would be in the 
 position of a parrot that echoes words without under- 
 standing them. 
 
 Words, then, are not indispensable to thought. 
 A congenitally deaf person that has not mastered 
 language can carry on an inteUigent conversation 
 in demonstrative and imitative gesture. A person 
 may lose all memory of words (a pathological con- 
 dition known as amnesia verbalis, or verbal amnesia), 
 and yet maintain a high order of intelligence. 
 This is accounted for by the fact that much of our 
 ordinary thought proceeds in visual, auditory, and 
 kinaesthetic imagery. Concrete objects are thought 
 
 ^ We might introduce kinaesthetic images at this point. As the 
 subject of voluntary muscular movements has not yet been fully 
 discussed, the kinaesthetic images are omitted. 
 
INTRODUCTION 21 
 
 of in visual terms, and their names may be totally 
 ignored.^ 
 
 Abstract thought, as well as concrete thought, may 
 proceed in non-verbal imagery. The writer finds 
 that much of his abstract thought is conducted in 
 visual and motor terms, the motor images being 
 frequently those of eye-movements. Considered with 
 reference to their content, the images are meagre and 
 rudimental ; considered in regard to their function, 
 they are frequently more cogent than elaborate col- 
 locations of verbal images. The writer was recently 
 listening to a discussion concerning a parabola, in 
 which the explanation was somewhat desultory. A 
 visual image of a parabola was in the mind. During 
 the discourse the method of handHng the subject was 
 suddenly criticized — as it were, in an undercurrent 
 of consciousness — by a thought whose content was 
 nothing more than a mental glance across the arms of 
 the parabola, and then around its contour. The 
 following verbal interpretation of the thought was 
 written within three minutes of the occurrence of 
 the incident : ''A person that is not a logical thinker 
 is apt to proceed on the assumption that his auditor's 
 mental imagery is identical with his own. He dis- 
 cusses particular details simply and solely because 
 some point in his imagery happens to attract his 
 
 ^ Consequently the names of concrete objects are often forgotten 
 first in old age. 
 
22 THE PSYCHOLOGY OF STAMMERING 
 
 attention; for this reason the method of procedure 
 is entirely adventitious. The methodical thinker, on 
 the other hand, first examines his mental imagery 
 and assures himself that it is adequate to the discus- 
 sion; then he builds up, piece by piece, the same 
 imagery in the mind of the hearer. This done, they 
 talk to an identical purpose." The glance across the 
 parabola symboKzed the desultory thought. The 
 glance around its contour represented the methodical 
 procedure. The two processes were mentally con- 
 trasted. As an interpolation, the thought would have 
 been too involved to find expression in words, for the 
 attention deviated scarcely a moment from the words 
 of the speaker. 
 
 Much of one's thinking is, however, conducted in 
 verbal imagery. Language originated as a means 
 of communication ; ^ but it has become an instrument 
 of thought for the reason that words have become 
 nuclei of concepts. As concepts grow more abstract 
 
 ^ The earliest linguistic efforts are supposed to have been imita- 
 tive emotional cries. "When English woe is traced back to Anglo- 
 Saxon wa, it is found to be an actual groan turned (like the German 
 weh) into a substantive expressing sorrow or distress." (Tylor, 
 ''Anthropology," p. 126.) A further advance in evolution would be 
 represented by the addition of onomatopoetic, or imitative, words. 
 Such, for instance, are the words buzz, hum, clatter, ding-dong, pewit, 
 mew, etc. Words of this kind would soon lose all trace of their 
 origin. This can be readily understood when one notices the great 
 dissimilarity between English and German words that were once 
 identical. 
 
INTRODUCTION 23 
 
 and general, the representation becomes more largely 
 verbal, and less and less visual. Ideas of integrity, 
 thriftlessness, incompatibility, plasticity, speed, etc., are 
 with many people almost purely verbal in their rep- 
 resentation. Consequently these people find mental 
 language indispensable for abstract thought ; though 
 their concrete ideas may be portrayed in other forms 
 of imagery. Many people are greatly reduced in 
 intelligence when suffering from verbal amnesia. 
 
 It is by no means essential, however, that the ab- 
 stract concept be built up around the spoken word. 
 The nucleus may just as well be a graphic representa- 
 tion, — a diagram, an Egyptian hieroglyph, a con- 
 ventional scriptory symbol. In the case of deaf- 
 mutes it may be a gesture, or a sign in the manual 
 alphabet, — mentally represented in visual or motor 
 terms. With the bhnd, the nucleus of a concept may 
 be a tactile image of raised print. In the case of 
 the deaf-blind it may be a word tapped out (by the 
 Braille system) into the palm of the hand. The 
 imagery may be in either kinaesthetic or tactile terms, 
 — the subject imagines himself tapping the words into 
 the palm of another person, or imagines the words 
 being tapped into his own hand. 
 
 The concept-nucleus is, then, often entirely arbi- 
 trary. It makes no difference whether a horse is 
 called horse, pferd, or cheval. It makes no difference 
 whether the word integrity is heard as sound, is seen 
 
24 THE PSYCHOLOGY OF STAMMERING 
 
 as marks on paper, or is felt as somebody's 
 finger-movements in one's hand. The meaning of 
 these symbols inheres in the congeries of associated 
 mental images that are either overtly or nascently 
 aroused. 
 
CHAPTER II 
 
 MENTAL TYPES: EYE-MINDEDNESS, EAR-MINDED- 
 
 NESS, ETC. 
 
 As Ribot has appropriately remarked, we have 
 memories rather than memory. We have, as it were, 
 a number of separate and individual minds, — an 
 auditory mind, a visual mind, a kinaesthetic mind, a 
 tactile mind, and so on. These minds may be con- 
 jointly or separately active. One may think simply 
 of the appearance of a rose, or he may think simul- 
 taneously of its appearance, its fragrance, and the 
 softness of its petals. 
 
 One or more of these minds may be entirely lacking. 
 A blind person has no images of sight ; a deaf person, 
 no images of hearing. The deaf-bhnd have images 
 for neither of these senses. A child that becomes 
 bhnd before the age of six or seven loses his visual 
 memory. Similarly, a child becoming deaf loses all 
 imagery of sounds. In the case of Laura Bridgman 
 — who, as a child, suffered loss of the senses of sight, 
 hearing, taste, and smell — the world of sensation 
 and memory would be almost exclusively tactile and 
 kinaesthetic. There must, then, be considerable 
 difference in the workings of individual minds. 
 
 25 
 
26 THE PSYCHOLOGY OF STAMMERING 
 
 "Sounds certainly play a far more prominent part in the 
 mental life of the blind than in our own. In taking a walk 
 through the country, the mutations of sound, far and near, 
 constitute their chief delight. And to a great extent their 
 imagination of distance and of objects moving from one distant 
 spot to another seems to consist in thinking how a certain 
 sonority would be modified by the change of place." ^ 
 
 A congerdtally deaf person could have no such ex- 
 perience. For him, sensations and memory of hear- 
 ing have no existence. He sees things, and remembers 
 their appearance. The blind man hears them, and 
 retains the memory of their sound. Each is able to 
 think in terms that the other is totally unable to 
 comprehend. 
 
 A person possessed of all the different senses is 
 able to experience sensations of every type. It does 
 not follow, however, that he can think equally well 
 in all types of mental imagery. The different mem- 
 ories are not equally developed. Most people are 
 practically devoid of imagery for taste and smell; 
 some have little memory for sights and sounds. In 
 remembering the ocean, one man sees the waves as 
 they break upon the shore; another hears them; 
 a third may feel the damp spray as it is blown into 
 his face; and still a fourth may smell seaweed and 
 brine. One man is eye-minded, thinking in terms of 
 sight; another is ear-minded, thinking in terms of 
 sound; still another is motor-minded, thinking in 
 1 James, "Principles of Psychology," Vol. II, p. 205. 
 
MENTAL TYPES 27 
 
 terms of muscular movements. The eye-minded man 
 is called a visile, visuel, or visionaire; the ear-minded 
 man, an audile, auditeur, or auditaire; the motor- 
 minded man is a motile, moteur, or motaire. There is 
 also a type called the tactile. This type is found 
 perhaps almost exclusively among the blind. The 
 person of the mixed type, the indifferent, thinks equally 
 well in any form of mental imagery. 
 
 The visile remembers best that which he sees; 
 the audile, that which he hears ; and the motile or 
 tactile, that which he feels. Actors have different 
 ways of learning their parts. One reads his part 
 from the printed page, and learns through the visual 
 imagery ; another has the part read aloud to him, and 
 relies upon his acoustic memory ; still a third writes 
 his part, and depends upon his visual and motor 
 memories ; or he may read the part aloud, and recall 
 the words by their sound and feehng. To test the 
 spelling of a word, one man mentally repeats the let- 
 ters or utters them aloud. He judges of the accuracy 
 by sound. Another must see the word in writing, or 
 must "picture " the written word before him. A third 
 executes the writing movements before he is sure of 
 the spelHng. After a tedious train journey the visile 
 sees the different incidents of his tiresome ride; the 
 audile hears the clangor and rumble of the train; 
 and for hours the motile may feel its swaying.^ 
 
 ^ This last memory is, strictly speaking, not in kinaesthetic 
 
28 THE PSYCHOLOGY OF STAMMERING 
 
 The different image-types are not mutually ex- 
 clusive. The visile does not think solely in visual 
 imagery; his visual imagery merely predominates. 
 In some cases, however, the thought-processes are 
 conducted almost exclusively in the predominant 
 form of mental imagery. 
 
 Not only is the prevalent image-t5^e different with 
 different persons, but in persons with the same type 
 of mind the prevalent images may differ in intensity. 
 Of two visiles, one will have optical images that differ 
 little from sensations of sight, the other will have 
 images that are rudimentary and schematic. In some 
 cases the images are highly colored; in others, they 
 appear only in light and shade. In the same person 
 the mental imagery may vary greatly with the physical 
 condition. Frequently the visual imagery becomes 
 intense and highly colored during physical or mental 
 fatigue. The perspicuity of visual imagery in iso- 
 lated cases is demonstrated by feats of blindfold 
 chess-playing. Some experts will, when blindfolded, 
 conduct as many as sixteen or twenty games simul- 
 taneously, and win a majority of them. Each board, 
 with the position of its men, must be clearly visual- 
 ized; and as the player goes from board to board, 
 he must remember the groupings of the pieces as he 
 
 terms. The images are of static sensations, — sensations derived 
 from movements of the whole body rather than of parts of it. 
 These particular images seem to be particularly strong, however, in 
 some motiles. 
 
MENTAL TYPES 
 
 29 
 
 left them. A couple of such experts can conduct 
 an imaginary game as they walk upon the street. 
 Some artists find their visual images so distinct that 
 they can dispense with their models after a single 
 sitting.^ Vivid mental images frequently border 
 upon hallucinations. Gal ton says : 
 
 "A well-known frequenter of the Royal Institution tells me 
 that he often craves for an absence of visual perceptions [images], 
 they are so brilliant and persistent." ^ 
 
 Galton conducted systematic inquiries into dif- 
 ferences in mental imagery. He requested his sub- 
 jects to describe, among other things, their memory of 
 the breakfast table. This question has now become 
 classical. The two following reports, taken "from 
 returns, furnished by 100 men, at least half of whom 
 are distinguished in science or in other fields of intel- 
 lectual work," illustrate the extremes of brilHancy and 
 obscurity in visual imagery : 
 
 "'Thinking of my breakfast table this morning, all the ob- 
 jects in my mental picture are as bright as the actual scene."' ^ 
 
 The second report runs : 
 
 " 'My powers are zero. To my consciousness there is almost 
 no association of memory with objective visual impressions. I 
 recollect the breakfast table, but do not see it. " ' ^ 
 
 1 See Ballet, "Le langage interieur et I'aphasie," 2ded., pp. 36-37. 
 
 2 " Inquiries into Human Faculty and its Development," p. 97. 
 ' Lac. cit., p. 89. ^ Loc. cit., p. 92. 
 
30 THE PSYCHOLOGY OF STAMMERING 
 
 James quotes the following introspective descrip- 
 tions by two of his psychology students : ^ 
 
 "'This morning's breakfast table is both dim and bright; it 
 is dim if I try to think of it when my eyes are open upon any 
 object ; it is perfectly clear and bright if I think of it with my 
 eyes closed. AU the objects are clear at once, yet when I con- 
 fine my attention to any one object it becomes far more distinct. 
 — I have more power to recall color than any other one thing : 
 if, for example, I were to recall a plate decorated with flowers, 
 I could reproduce in a drawing the exact tone, etc. The color 
 of anything that was on the table is perfectly vivid. — There is 
 very Httle limitation to the extent of my images : I can see all 
 four sides of a room, I can see all four sides of two, three, four, 
 even more rooms with such distinctness that if you should ask 
 me what was in any particular place in any one, or ask me to 
 count the chairs, etc., I could do it without the least hesitation. — 
 The more I learn by heart the more clearly do I see images of 
 my pages. Even before I can recite the Hues I see them so that 
 I could give them very slowly word for word, but my mind is so 
 occupied in looking at my printed image that I have no idea 
 of what I am saying, of the sense of it, etc. When I first found 
 myself doing this I used to think it was merely because I knew 
 the Unes imperfectly ; but I have quite convinced myself that 
 I really do see an image. The strongest proof that such is 
 really that fact is, I think, the following : 
 
 "'1 can look down the mentally seen page and see the words 
 that commence all the lines, and from any one of these words I 
 can continue the line. I find this much easier to do if the words 
 begin in a straight Une than if there are breaks.'" 
 
 The second description gives the other extreme in 
 visual imagery : 
 
 1 "Principles of Psychology," Vol. H, pp. 56 f. 
 
MENTAL TYPES 
 
 31 
 
 "'My ability to form mental images seems, from what I 
 have studied of other people's images, to be defective, and 
 somewhat peculiar. The process by which I seem to remember 
 any particular event is not by a series of distinct images, but a 
 sort of panorama, the faintest impressions of which are per- 
 ceptible through a thick fog. — I cannot shut my eyes and get a 
 distinct image of anyone, although I used to be able to a few 
 years ago, and the faculty seems to have gradually slipped 
 away. — In my most vivid dreams, where the events appear 
 like the most real facts, I am often troubled with a dimness of 
 sight which causes the images to appear indistinct. — To 
 come to the question of the breakfast table, there is nothing 
 dejfinite about it. Everything is vague. I cannot say what I see. 
 I could not possibly count the chairs, but I happen to know that 
 there are ten. I see nothing in detail. — The chief thing is a 
 general impression that I cannot tell exactly what I do see. 
 The coloring is about the same, as far as I can recall it, only wtry 
 much washed out. Perhaps the only color I can see at all dis- 
 tinctly is that of the table-cloth, and I could probably see the 
 color of the wall-paper if I could remember what color it was.' " ^ 
 
 The following account, from another source, shows 
 strong auditory and tactile imagery : ^ 
 
 "*In recalhng a fire which I witnessed I can hear the church 
 bells ringing out the alarm, and can plainly distinguish between 
 the deep tones of one and the higher pitch of the other. All the 
 confusion of sounds now comes to me — the shouting from dif- 
 ferent quarters of the town, the sound of footsteps on the board 
 sidewalks, even the sound of my own breathing and puflSng 
 and of those running by my side. I have no really distinct 
 
 1 James, loc. cit., p. 57. 
 
 ' Scott, "Psychology of Public Speaking," pp. 26 f. 
 
32 
 
 THE PSYCHOLOGY OF STAMMERING 
 
 vision of the fire itself, but can hear the cracking of breaking 
 glass, the pecuUar roar of a huge blaze, and the excited voices 
 of the crowd. The picture is one of confusion, and noise pre- 
 dominates. I can easily see in imagination the faces of my 
 acquaintances, but it is easier to hear their voices. In playing 
 accompaniments to mandolin pieces upon a guitar, I derive 
 almost the same amount of pleasure whether the other instru- 
 ments are present or not. My imagination supphes all the 
 absent parts. I can accompany and hear an air which is too 
 difficult for me to render on a piano or by whistling; in my 
 imagination every note is vivid. As for images of touch, they 
 are most vivid to me when I hear or listen to accounts of sur- 
 gical operations. If such accounts refer to a broken leg, there 
 is a painful sensation in that part of my anatomy, and I fear to 
 step with that leg lest I hurt it. If I see a fly crawhng on 
 any one, I have an intense desire to brush it off, and feel re- 
 Heved if I rub my face vigorously in the corresponding part.' " 
 
 The next report (a reply to definite questions) shows 
 extremely weak acoustic imagery : ^ 
 
 "'I am not able to state whether I hear the train or not. I 
 am incHned to think that it is a noiseless one. It is hard for me 
 to conceive the sound of a bell, for instance. I can see the bell 
 move to and fro, and for an instant seem to hear the ding-dong, 
 but it is gone before I can identify it. When 1 try to conceive 
 of shouts, I am like one groping in the dark. I cannot possibly 
 retain the conception of a sound for any length of time.' " 
 
 Wilfred Lay describes his own auditory imagery 
 in the following terms : ^ 
 
 1 Scott, loc. cit., p. 24. 
 
 2 "Mental Imagery," Psychological Review, Monograph Supple- 
 ment No. 7, p. 36. 
 
MENTAL TYPES 33 
 
 "I find the auditory mental imagery in my case to be almost 
 as important a factor in my mental life as is the visual, being 
 a mental reproduction of the sounds I have heard — musical 
 or otherwise. They are comparable with real sounds not so 
 much in intensity, but? perfectly with timbre, pitch, and dura- 
 tion. I can estimate a minute with much greater exactness 
 mentally, if I listen to the auditory mental imagery of a piece 
 of music which takes about a minute to perform." 
 
 The present writer can report the converse in 
 auditory imagery. Apart from an auditory-motor 
 memory for words (in which the auditory element is 
 signally weak) he has no memory for sotmd what- 
 ever. 
 
 The motor memory has been a good deal neglected 
 by psychologists, — probably because vivid motor 
 imagery is somewhat rare, and fugitive images are 
 difficult to introspect. The subjoined account gives 
 a description of clear motor memory : ^ 
 
 " ' My mental imagery seems to be of the motile type, strongly 
 characterized by a sense of position and direction. My visual 
 images are poor. I can only obtain the visual image of a 
 familiar face by successively giving my attention to the separate 
 features ; the whole face does not appear to my mind. A 
 word is indelibly fixed in my mind if I trace its characters on 
 the palm of my left hand with the forefinger of my right. The 
 mention of an author or a book brings up the position which 
 that work occupies on the shelves with which I am familiar, 
 but does not call up the looks of the surroundings. The idea 
 of the cardinal points of the compass never leaves me, though 
 
 ^ Scott, "The Psychology of Public Speaking," p. 25. 
 
34 THE PSYCHOLOGY OF STAMMERING 
 
 it is frequently a mistaken one. In the city of Chicago my 
 only guide is this sense of direction, which seldom leads me 
 astray. I doubt my ability to locate by streets or by adjacent 
 structures, the buildings with which I am most famihar. Words 
 representing things that I have seen always give me a sense of 
 their direction and position. Other words are invariably as- 
 sociated with the feeling of articulating them. In the act of 
 writing, each letter is mentally pronounced. Among my early 
 memories is one of firing a revolver. I remember pulling the 
 trigger, but not the report that followed.'" 
 
 Galton mentions the circumstance of a young 
 Indian's following the outline of a drawing in the 
 Illustrated News with the point of his knife, in order, 
 as he explained, that he might "remember the better 
 how to carve it when he returned home." ^ Obvi- 
 ously he was resorting to his motor memory. 
 
 The motor memory appears to be weak in the 
 majority of persons. Bastian, in the following 
 lines, attests the feebleness of his own kinaesthetic 
 imagery : 
 
 "Let him [the reader] close his eyes, and with pen in hand 
 make movements in the air as though he were writing the word 
 'London.' He may thus assure himself that he has a set of 
 sensations accompanying these movements. After an interval, 
 say the next day, let him again close his eyes, and, without 
 making any movement, attempt to recall 'in idea' the muscular 
 and other sensations he previously experienced when writing 
 the above-mentioned word. Let him then contrast his com- 
 parative powerlessness in this direction, with his ability to recall 
 
 * "Inquiries into Human Faculty and Its Development," p. 97. 
 
MENTAL TYPES 35 
 
 in idea the visual appearance of this word when written or its 
 corresponding sound." ^ 
 
 The comparative powerlessness to recall kin aes- 
 thetic impressions has no existence for the motile. 
 The present writer, whose motor images are ex- 
 tremely vivid, can recall these movements with the 
 utmost facility, but he finds it difi&cult to recall 
 the visual or auditory image. The writer well re- 
 members that, long before he knew anything of 
 mental imagery, he would practise pieces on the 
 piano by performing the more difficult passages in 
 kinaesthetic imagery of finger-movements. He could 
 play from memory ; though this memory was purely 
 visual and motor, the auditory musical imagery 
 being non-existent. The writer takes an amateur's 
 interest in card tricks. Recently he was acquir- 
 ing some new sleights of hand, and frequently prac- 
 tised them in motor imagery while walking in the 
 street. 
 
 Sufficient has been said to show that there is a great 
 diversity in individual minds ; that human minds are, 
 in fact, as different as human faces. There is a dif- 
 ference both in the type of imagery employed, and 
 in the intensity of the imagery itself. With some 
 persons a particular form of memory may never de- 
 velop : there is congenital amnesia. Olfactory and 
 gustatory amnesia are too common to be abnormal. 
 ^ "Aphasia and Other Speech Defects," p. 10. 
 
36 THE PSYCHOLOGY OF STAMMERING 
 
 Musical amnesia, too, occurs with the greatest fre- 
 quency. It is recognized as the lack of a "musical 
 ear." Auditory amnesia (for the more ordinary 
 physical sounds) is congenital in many persons. 
 Visual amnesia is more rare, but, as James says, 
 ''some people undoubtedly have no visual images 
 at all worthy of the name." 
 
 As regards the difference in intensity, Galton has 
 estabhshed the fact that men of science, or, in general, 
 men eminent in the field of intellectual work, are 
 strikingly deficient in visualizing powers. — Vivid 
 mental pictures would be Hkely to divert the attention 
 in abstract thought. These images probably be- 
 come vestigial because the thinker attends to the 
 relations between them, and ceases to regard them 
 for their content. To a considerable extent visual 
 images are supplanted by verbal thought. — Galton 
 further ascertained that "the power of visualizing is 
 higher in the female sex than in the male," and that 
 it is stronger in children than in adults. 
 
 More extensive inquiries would probably have 
 ehcited the fact that auditory imagery is more prom- 
 inent in females. There appears no a priori reason 
 why the greater intensity should be Kmited to one 
 particular class of mental imagery. There seems to 
 be a correlation, as regards intensity, between the 
 different forms of mental imagery. From inquiries 
 among 125 artists and sculptors (who must per- 
 
MENTAL TYPES 37 
 
 force have strong visual imagery) Lay found that 
 92 per cent could recall music with sufficient clear- 
 ness to derive pleasure from the imagery. Sixty- 
 eight per cent derived pleasure from the memory 
 of fruit — presumably from the . gustative memory. 
 These percentages are sufficiently high to suggest 
 the correlation mentioned. The greater clearness 
 of the mental imagery in the female sex would readily 
 account for woman's greater conversableness, the 
 more intense verbal imagery finding a more ready 
 expression in articulate speech. The same phe- 
 nomenon would account for the earlier acquisition 
 of speech by girls. 
 
 The clearness of mental imagery is by no means 
 correlated with the keeness of sense-perception. A 
 person may have little visual memory, but still be 
 quick to recognize faces. He may have no memory 
 for colors, but may be able to distinguish the finest 
 differences of shade. He may be devoid of auditory 
 imagery, and yet readily recognize voices. He may 
 possess not a vestige of musical memory, and yet have 
 a keen appreciation for music. Furthermore, there 
 is no essential connection between the imagery of the 
 waking state and the imagery of dreams. One may 
 be ordinarily destitute of auditory imagery, and yet 
 dream in terms of sound. During illness, such a per- 
 son may have hallucinations or pseudo-hallucina- 
 tions of hearing. 
 
38 THE PSYCHOLOGY OF STAMMERING 
 
 Among the curiosities of mind are certain bizarre 
 associations of mental imagery. This associational 
 process is known as syncBSthesia. Many people, 
 when listening to music, associate the tones with 
 mental images of color. Thus a veritable kaleido- 
 scopic performance goes on in the mind. This 
 particular form of association is known as color- 
 atidition, or chromcesthesia. Other people associate 
 colors with tastes. Yellow may be salt; green, 
 acid ; red, peppery ; etc. 
 
 Many persons employ mnemonic devices, known as 
 number-forms, in recalling numerals, days of the week, 
 months of the year, etc. When they think of a date 
 or hear one mentioned, they immediately associate 
 it with its particular position on a ^' visual'^ calendar. 
 Hours of the day are associated with the position 
 of the hands on a "visual" timepiece. These as- 
 sociations are invariable in the same person, but 
 are seldom alike in two different people. They occur 
 more frequently in females than in males, and are 
 more common among children than among adults. 
 Usually they have existed too far back for the memory 
 to determine their origin. 
 
 " Traces of the origin of the Forms that appear here and there 
 are dominoes, cards, counters, an abacus, the fingers, counting 
 by coins, feet and inches (a yellow carpenter's rule appears in 
 one case with 56 in large figures upon it), the country surround- 
 ing the child's home, with its hills and dales, objects in the gar- 
 den (one scientific man sees the old garden walk, and the nu- 
 
MENTAL TYPES 39 
 
 meral 7 at the tub sunk in the ground where his father filled his 
 watering pot). Some associations seem connected with the 
 objects spoken of in the doggerel verses by which children are 
 often taught their numbers." ^ 
 
 In his *' Inquiries into Human Faculty" Gal ton 
 gives nearly seventy illustrations — many of them 
 in colors — representing different mnemonic devices. 
 The following is one of the descriptions showing 
 associations between numerals and colors : ^ 
 
 " 'Up to 30 I see the numbers in clear white ; to 40 in gray ; 
 40-50 in flaming orange ; 50-60 in green ; 60-70 in dark blue ; 70 
 I am not sure about ; 80 is reddish, I think ; and 90 is yellow ; 
 but these latter divisions are very indistinct in my mind's eye.' " 
 
 In another case the numerals from i to 9 appear 
 in different colors : i is black ; 2, yellow ; 3, pale 
 brick-red; 4, brown; 5, blackish gray; 6, reddish 
 brown; 7, green; 8, bluish; 9, reddish brown, 
 *' somewhat Kke 6." The colors are very distinct 
 when the numbers occur separately. In compounds 
 they are less clear. For historical dates the num- 
 bers appear upon a colored background that resembles 
 the particular hue of the principal figure indicating 
 the century. 
 
 In many cases the letters of the alphabet, par- 
 ticularly the vowels, are invested with color. This 
 subject will recur in the final chapter. 
 
 * Gahon, "Inquiries into Human Faculty and Its Development," 
 p. 128. ^ Loc. cit., p. 141. 
 
CHAPTER III 
 
 THE VERBAL IMAGE 
 
 A LANGUAGE is any system of symbols used pri- 
 marily for the expression of thought. The symbol 
 is the nucleus of a concept. When used as a means of 
 communication, it is intended to make known — by 
 means of its associations — the thought passing in 
 the mind of the person employing it. Language is 
 not necessarily speech. We have a written language, 
 a language of gestures, a manual language, and so on. 
 Had we lived in a world with no enveloping atmos- 
 phere, it would have been impossible for the evolving 
 race to communicate by means of acoustic symbols; 
 that is, by vocal speech. With no air to convey 
 sound-waves, there would have been no sense of 
 hearing. For communication, the race must per- 
 force have resorted to the only other distance-receptor 
 available, — the sense of sight. There would then 
 have developed a complex language of gestures, or 
 perhaps a manual or a labial language. Sight and 
 feeHng would be the only two senses involved. 
 
 It has been shown in Chapter I that the concept- 
 nucleus may be almost any mental image whatever. 
 
 40 
 
THE VERBAL IMAGE 41 
 
 With the deaf-mute, the nucleus may be a visual 
 or kinagsthetic image of certain finger-movements. 
 With the deaf-blind, the language-concept is still 
 further limited ; it is a tactual or motor representa- 
 tion of finger-movements. These cases are admittedly 
 exceptional. They are cited to emphasize the fact 
 that language is not necessarily represented in the 
 mind by auditory memory-images of spoken words. 
 
 In this chapter, spoken language will be the chief 
 subject of consideration. Spoken language does not, 
 however, involve merely the sense of hearing. Words 
 are distinctly felt as they are uttered : the movements 
 of the Hps, tongue, and larynx are as much a part of 
 the verbal concept as are the sounds that these move- 
 ments produce. Further, these oral movements can 
 be seen. Lip-reading becom.es an accomplishment 
 among the deaf, and for the interpretation of speech 
 the sense of sight serves them almost as well as would 
 the sense of hearing. Spoken language, then, may in- 
 volve the three senses of hearing, feeHng,^ and vision ; 
 and the mental representation may be in terms of 
 mental images pertaining to any one of these senses. 
 In normal cases, vision naturally plays no conspicuous 
 part. 
 
 The matter becomes slightly more complex when 
 written language is considered in addition to spoken 
 language. In the act of writing, both kinaesthetic 
 ^ Accepting feeling for the time being as a unitary sense. 
 
42 THE PSYCHOLOGY OF STAMMERING 
 
 and visual sensations are present. In the act of read- 
 ing, vision alone is involved. 
 
 From the above discussion it is evident that the 
 verbal image may be represented in any one of a 
 variety of elemental forms, or that it may subsist 
 in the mind as a complex of several elementary images. 
 With the educated person there is, in addition to 
 the auditory and kinaesthetic images of the spoken 
 word (with occasionally a visual representation), 
 a visual and a motor image of the written symbol. 
 It was shown in Chapter II that different t5^es of 
 images are present in different minds with var3dng 
 degrees of prominence. Thus it is naturally to be 
 expected that there should exist different types of 
 verbal thought with different persons, — that the 
 audile should think of the sound of the word, the 
 motile of its feeling, and the visile chiefly of its graphic 
 representation. It is seldom, of course, that one type 
 of imagery prevails to the exclusion of all others. 
 In the audile, hearing predominates ; in the articulo- 
 moteur, the memory of feeling is preponderant; in 
 the audito-moteur J the two elements may be equally 
 conspicuous. 
 
 People of the visual verbal type are rather rare, yet — 
 
 "Some few persons see mentally in print every word that 
 is uttered ; they attend to the visual equivalent and not to the 
 sound of the words, and they read them ofiE usually as from a 
 long imaginary strip of paper, such as is unwound from tele- 
 
THE VERBAL IMAGE 43 
 
 graph instruments. The experiences differ in detail as to size 
 and kind of type, color of paper, and so forth, but are always 
 the same in the same person." ^ 
 
 These visual images appear also in silent thought, 
 but they are more in evidence when the subject is 
 speaking, or is listening to the words of another person. 
 Frequently the words appearing before the mind are 
 written instead of printed. 
 
 In silent thought the words are, as a rule, mentally 
 pronounced. But this is not invariably the case; 
 sometimes the appreciation of the word is purely 
 visual. One may read printed words in much the 
 same way as he would read Indian picture-writing 
 or Egyptian hieroglyphics; i.e. without necessarily 
 having recourse to spoken words or their memory- 
 images. The reading of a foreign language is often 
 largely visual where knowledge of it happens to be 
 deficient ; though the average person would, of course, 
 improvise a pronunciation that would serve all the 
 purposes of the most exact verbal imagery. In read- 
 ing numbers or foreign names, the appreciation is 
 often entirely visual. Few persons would stop to 
 bestow more than a schematic pronunciation upon 
 such a word as Nizhn-Udinsk. Still fewer would 
 accord the full titulary dignity to such a number as 
 6,328,087,628,041 ; its value — like that of a number 
 
 ^ Galton, "Inquiries into Human Faculty and Its Development," 
 p. 97. 
 
44 THE PSYCHOLOGY OF STAMMERING 
 
 expressed in Roman numerals — would be under- 
 stood in a general way without being interpreted in 
 words. Similarly the visile understands his mental 
 words without pronouncing them. He thinks much 
 as the deaf-mute reads; that is, by associating the 
 printed word directly with the images that give it 
 meaning. But, as already stated, the visile usually 
 pronounces his words mentally after they have 
 appeared in the visual form. The process merely 
 starts with the visual image, and is consummated 
 when the word is mentally heard or spoken. 
 
 In exceptional cases words may present themselves 
 to the visile as optical images of articulative move- 
 ments. This t3^e of verbal memory is present to 
 an extent among the congenitally deaf that have 
 learned oral speech by sight and feeling. The visual 
 images, however, are accompanied by memories of 
 feehng, which undoubtedly play a prominent part 
 in verbal thought. 
 
 The mental hearing or mental pronouncing of a 
 word represents the most common type of verbal 
 imagery. The average person would testify without 
 a moment's hesitation that, when he thinks in words, 
 he hears the words in his mind. In most cases the 
 statement would be true ; but in most cases, too, it 
 would represent but a part of the truth. The average 
 person feels his words just as much as he hears them. 
 His verbal image is a complex. This is especially 
 
THE VERBAL IMAGE 45 
 
 true when verbal thought is about to find expression 
 in speech. It will be best to treat the matter sys- 
 tematically and to show : first, that the verbal 
 imagery may in some cases be purely auditory ; 
 secondly, that in others it may be purely kinaesthetic ; 
 and thirdly, that with most persons it is composite, 
 being both kinaesthetic and auditory. 
 
 To begin with the pure auditory image : As there 
 exists an auditory memory for music and the com- 
 moner physical sounds, so there exists a purely 
 auditory memory for spoken words. The evidence 
 in support of this fact is conclusive. An audile will 
 occasionally hear a number of voices simultaneously. 
 Manifestly, such verbal imagery could not subsist 
 in kinaesthetic terms : it is heard ; it could not pos- 
 sibly be felt. Occasionally the subject imagines that 
 he is himself speaking in concert with a number of 
 other people. In this case his own speech may be 
 kinaesthetically represented, but the speech of the 
 other persons must be purely auditory. The writer 
 recently had an experience of this kind during a dream. 
 He was listening to the excellent singing of a chorus 
 of about thirty voices. Occasionally his own voice 
 would intrude, much to the detriment of the melody. 
 The singing of the chorus was purely auditory ; ^ 
 the voice of the writer was auditory-motor. 
 
 1 With the writer, no such auditory imagery appears during the 
 waking state. 
 
46 THE PSYCHOLOGY OF STAMMERING 
 
 As further evidence that verbal imagery may be 
 purely auditory, we have the testimony of some 
 psychologists that they hear their words when they 
 think. Egger says/ "My internal utterance is an 
 imitation of my voice." In another passage he com- 
 pares mental language to an echo. Bastian ^ finds 
 that his verbal imagery is chiefly auditory, and that 
 the kinaesthetic images of words are scarcely recover- 
 able. Titchener ^ quotes the following introspective 
 description of auditory verbal imagery: "^The R 
 seemed to ring through my head. Letters came by 
 sound; I did not speak them.'" Many people have 
 auditory images of words during the primary memory. 
 As they listen to the after-sensation, or mental-echo, 
 of words they have just heard pronounced, they hear 
 them "ringing in the head." 
 
 As further evidence that verbal memory is often in 
 acoustic terms, we have the fact that many people 
 lose all memory of words when that brain-centre is 
 destroyed in which auditory memory resides."* 
 
 And now for the kinaesthetic imagery. What proof 
 have we of its importance? It has sometimes been 
 argued that, since the deaf child remains dumb be- 
 cause of lack of hearing, the auditory imagery must 
 
 1 "La parole int&ieure," 2d ed., p. 67. 
 
 '"Aphasia and Other Speech Defects" and "The Brain as 
 an Organ of Mind." 
 
 ' " Experimental Psychology," Part H, Vol. I, p. 399. 
 
 * The subject of brain-centres will be discussed in the next chapter. 
 
THE VERBAL IMAGE 47 
 
 necessarily be the most important element in verbal 
 thought. The argument is fallacious. Even the 
 person possessed of hearing may have practically 
 no secondary auditory memory, — yet he thinks in 
 words and speaks with perfect fluency. During the 
 learning-process, in such cases, the child uses his 
 kinaesthetic and primary auditory memories; or he 
 may use hearing merely as a guide, learning chiefly 
 by feeHng and correcting himself by ear. In either 
 case the words are remembered in terms of feehng; 
 that is, in kinaesthetic imagery. 
 
 The child that is born deaf would never learn to 
 speak, or think in words, if internal language were 
 entirely dependent upon auditory memory. How- 
 ever, the child is taught to speak with considerable 
 fluency by using sight and feeHng as guides. The 
 words are then remembered largely in terms of 
 feeHng. Educated deaf people learn to speak with 
 such fluency, and to read the Hps of other speakers 
 with such readiness, that in many cases their con- 
 versation gives no evidence of their infirmity. In the 
 following words Kussmaul describes a conversation 
 he had with a deaf person that had been orally 
 taught : ^ 
 
 "One day I was engaged in conversation in the hospital 
 for a considerable time with an intelligent young bookbinder, 
 who was suffering from phthisis, without noticing anything 
 
 1 "Storungen der Sprache," 4th ed., p. 54. 
 
48 THE PSYCHOLOGY OF STAMMERING 
 
 abnormal in his speech except a loud voice and an unusually 
 measured and careful utterance. It was not till I had finished 
 the examination and taken my report of the case, that I learned 
 to my astonishment that I had before me a person that was 
 absolutely deaf." ^ 
 
 In such cases as this, words are remembered in 
 visual and kinaesthetic terms. There may be visual 
 images of the movements of the lips and tongue ; but 
 the action of the larynx, pharynx, soft palate, etc., 
 must in memory be "felt.'' These organs cannot 
 well be observed during speech; hence their action 
 cannot be visually remembered. Visual images are 
 not even necessary. Sight may be used merely as 
 a guide during the learning-process, and the words 
 may be retained only in terms of feeling. Helen 
 Keller, who was both blind and deaf, managed to 
 master speech solely by the sense of feeling. It is 
 evident that her words must be retained solely as 
 kinaesthetic images.^ 
 
 1 The speech of the educated deaf is usually lacking in proper 
 accentuation and inflection, — elements of speech that are not 
 readily felt. There is a somewhat impartial distribution of stress ; 
 thus the enunciation comes to resemble that of French, in which 
 articulation is vigorous and stress inconspicuous. 
 
 2 Miss Helen Keller was deprived of sight and hearing at the 
 age of nineteen months. Some years later she was taught to speak 
 "by feeling." In spite of her disabilities she managed to acquire a 
 thorough education. She graduated from Radcliile College with 
 the degree of Bachelor of Arts in 1904. Miss Keller has on several 
 occasions spoken from the public platform. See her "Story of my 
 Life," New York, 1908. 
 
THE VERBAL IMAGE 49 
 
 Among normal persons, the motile may remember 
 his words almost exclusively in terms of feeling. If he 
 happens to be deficient in auditory and visual memory, 
 there is no other way in which he can remember them. 
 Speaking of his mental words, Dodge says : ^ 
 
 "I spoke them. They were rudimentary, and for the most 
 part indistinct." 
 
 And again : ^ 
 
 "It is just as though I spoke the words — except for the 
 fact that the acoustic element is lacking. Often there are 
 actual movements of the lips and tongue. More frequently 
 I am uncertain whether these have taken place. In no case 
 were visual images or images of writing-movements detected. 
 Acoustic images were just as little in evidence. The words 
 had neither timbre, pitch, nor acoustic intensity. However, 
 they were not mere skeleton- words, such as pure movement- 
 images would represent ; they possessed on the contrary a 
 certain fulness that distinguished them in a characteristic 
 manner from other memory-images of simple mouth-move- 
 ments." 
 
 On a later page he says : ^ 
 
 "I am able to imagine quite clearly the movements that I 
 make in producing certain sounds, and I can analyze their 
 separate elements. Nevertheless, what is analyzed is cer- 
 tainly not auditory imagery." 
 
 His verbal thought is not represented by visual 
 images of printed words, for according to the author's 
 
 ^ "Die Motorischen Wortvorstellungen," p. 10. 
 ^ Loc. cit., pp. 11-12. ^ Loc. cU., p. 34. 
 
50 THE PSYCHOLOGY OF STAMMERING 
 
 account his visual images are inadequate for this 
 
 purpose : 
 
 "It is easy for me to command clear optical images of printed 
 or written letters. I can even visualize small groups of letters, 
 or short words. This faculty for visualizing with uniform clear- 
 ness ceases with words of four or five letters. I cannot always 
 picture four letters at once with uniform distinctness. When 
 the words are longer, I get a general picture — more or less 
 distinct — in which the letters become clear in quick succes- 
 sion. It is not meant that a single letter becomes clear and 
 then totally disappears, but rather that a small group of letters 
 grows clear in the confused picture, fading again as another 
 group rises into view. The speed of this emergence is deter- 
 mined by the audible or silent speech. The emergence itseK 
 usually takes place in syllables." ^ 
 
 It is evident from this account that Dodge does not 
 rely on his visual memory of words, but that his 
 verbal memory is purely kinaesthetic. 
 
 Another writer, Strieker, describes his verbal 
 imagery as being purely kinaesthetic. He compares 
 himself when engaged in silent thought to a piano- 
 player that runs his fingers over the keys without 
 actually striking them. The thought is portrayed 
 in movement, not in sound. ^ He says of an imaginary 
 conversation : 
 
 "I speak first for myself in motor word-images; then I 
 reply for the other party — also in motor word-images." ^ 
 
 ^ Loc. cit., p. 15. 
 
 2"Studien iiber die Sprachvorstellungen," p. 16. 
 
 ^Loc. cit., p. 93. 
 
THE VERBAL IMAGE 51 
 
 Strieker's primary auditory memory seems to be 
 
 clear, for he says : 
 
 "Immediately after a stranger has spoken to me, I can 
 easily recall his voice and the words that he uttered. This 
 memory gradually fades. The words remain in my memory; 
 but not always the voice. For instance, I can recall the exact 
 words with which a beggar accosted me in the street a few days 
 ago; I can recall his appearance, but I have not the faintest 
 memory of his voice." ^ 
 
 Strieker's secondary memory is apparently purely 
 kinaesthetic ; for he says of it : 
 
 "When I close my eyes to assist concentration, and allow 
 some verbal thought to pass through my mind, a familiar verse, 
 for instance (and ignore meanwhile specific occasions upon 
 which I have heard it) ; then I seek in vain for any memory of 
 sound that attaches itself to the words." ^ 
 
 With Strieker, distinctions between similar words are 
 felt, and not heard, for he says : 
 
 "Despite the manifold differences displayed by the letters 
 B, P, and M when they are actually pronounced, I find no 
 difference in them in thought but the characteristic labial 
 feelings. No matter how carefully I examine the words 'pater ' 
 and 'mater' in silent thought, I find that the only difference 
 between them is the feehng of the p or the w." ^ 
 
 Strieker, like Dodge, does not think in visual images 
 of words. His verbal memory is almost exclusively 
 kinaesthetic.^ 
 
 ^ Loc. cit., p. 19. 2 i^Qf^ cit., p. 19. 
 
 ^ Loc. cU., p. 10. * Loc. cit., p. 20. 
 
52 THE PSYCHOLOGY OF STAMMERING 
 
 The above introspections furnish convincing evi- 
 dence in support of a purely kinaesthetic verbal mem- 
 ory. If further e\ddence were necessary, it could be 
 found in the characteristics of certain pathological 
 cases. One or two of these will be cited in a later 
 chapter. In such cases, which are admittedly rare, 
 it is foimd that the patient retains command of 
 verbal thought and speech despite the fact that the 
 brain-centre is destroyed in which the auditory word- 
 images were stored. It is obvious that the word- 
 memories can remain only in terms of feeling. The 
 patient is an articulo-moteur . 
 
 But the average person is neither an articulo- 
 moteur nor an audile. He is an audito-moteur , and 
 his verbal imagery is of the mixed type. In recalHng 
 words, he both feels and hears them. This fact is 
 convincingly demonstrated by the various speech- 
 disturbances that follow the destruction or impair- 
 ment of either of the brain-centres that preside over 
 the kinaesthetic and auditory verbal memories. When 
 either of these centres is destroyed, internal language 
 is usually impaired. When only the auditory centre 
 is impaired, the patient often utters unintelligible 
 gibberish (jargon-aphasia). If his verbal memory 
 had been purely auditory, he would have become mute. 
 If it had been purely kinaesthetic, his language would 
 have remained unaffected. But the fact that his 
 speech becomes distorted shows conclusively that the 
 
THE VERBAL IMAGE 53 
 
 kinaesthetic centre is acting without the directory 
 influence of the auditory centre. These facts show 
 that the cooperation of both centres is usually requi- 
 site for normal internal speech. The matter will be 
 better understood after a perusal of the two suc- 
 ceeding chapters. 
 
 Introspection reveals the presence of both the motor 
 and auditory elements in the average person. Among 
 nearly a hundred persons, Strieker found only one 
 that was conscious of no feehng in the lips when 
 mentally pronouncing the letters M, B, and P. 
 Among nearly sixty, only two failed to detect these 
 feelings when reading.^ The average audito-moteur 
 is unable to think the explosive and labial consonants 
 clearly when the mouth is open and the tongue pro- 
 truded. The unnatural position of the articulative 
 organs seems to obstruct the incipient movements 
 that accompany articulation. Such words as bubble, 
 wobble, toddle, mimicry, kindergarten, etc., then appear 
 thick and unnatural, — as though one were speaking 
 them with the hps apart.^ 
 
 With many audito-moteurs the motor tendency is 
 so pronounced that actual movements of the speech- 
 organs occur during silent thought, and in exceptional 
 cases people may talk aloud instead of thinking to 
 themselves. 
 
 ^ Loc. cit., p, 49. 
 
 2 The difficulty disappears if the test is long continued. 
 
54 THE PSYCHOLOGY OF STAMMERING 
 
 Concerning the articulatory tendency Bain says: ^ 
 
 "When we recall the impression of a word or sentence, if 
 we do not speak it out, we feel the twitter of the organs just 
 about to conie to that point. The articulating parts — the 
 IsLrynx, the tongue, the lips — are sensibly excited ; a suppressed 
 articulation is in fact the material of our recollection, the in- 
 tellectual manifestation, the idea of speech." 
 
 And thus Wyllie:^ 
 
 "I find, when I mentally sing a song, with or without its 
 words, that it is impossible to prevent my pomum adami from 
 moving upwards when the melody passes into its highest 
 notes; but at the same time, I am most clearly conscious of 
 the varying pitch and cadence of the internal voice." 
 
 The present writer can distinctly feel the movements 
 of the larynx when thinking a vowel with rising in- 
 flection. The auditory image, however, is weak. 
 After thinking the vowel for a minute there is a dis- 
 tinct aching in the larynx, due beyond doubt to the 
 tension of the vocal cords. The writer has experi- 
 enced the same aching sensation in the larynx after 
 conversing for a quarter of an hour with a man that 
 was compelled by a throat affection to whisper. 
 
 This last phenomenon gives proof of sympathetic 
 movements during the act of listening. Many- 
 psychologists have described this inchoate articula- 
 tion. Thus Strieker, for instance: ^ 
 
 1 Bain, "The Senses and the Intellect," 4th ed., p. 357. 
 
 2 Wyllie, "Disorders of Speech," p. 237. ^ j^q(. ^^^^ p ^g^ 
 
THE VERBAL IMAGE 55 
 
 "I noticed these feelings first of all in the lips when any one 
 read to me with clear articulation. Each M, P, or B of the 
 speaker was accompanied by these labial feelings. Soon after- 
 wards I noticed that, when Hstening to clearly articulated 
 speech, I followed each word with an internal articulation of 
 my own." 
 
 Strieker finds further evidence of this concomitant 
 articulation in the fact that he remembers words 
 long after he has forgotten their sound. 
 
 Bain also makes reference to these sympathetic 
 speech-movements : 
 
 ''While intently listening to a speech, we are liable to follow 
 the speaker with a suppressed articulation of our own, whereby 
 we take the train of words into a vocal embrace, as well as re- 
 ceive it passively on the sense of hearing." ^ 
 
 The foregoing arguments should establish the prac- 
 tical universality of the motor tendency in internal 
 speech. Internal audition is, however, no less prev- 
 alent. Just as Strieker has found by inquiry that 
 ninety-nine persons in a hundred are conscious of 
 the motor tendency in silent speech, so the present 
 writer has ascertained that no less a proportion are 
 clearly conscious of internal audition. However, 
 this fact receives general recognition; it would be 
 supererogatory to argue in favor of it. Even Strieker 
 and Dodge are not entirely devoid of auditory 
 imagery. The latter says of his aural memory ; 
 
 1 Loc. cii., p. 371. 
 
56 THE PSYCHOLOGY OF STAMMERING 
 
 "In an imperfect manner I am able to redintegrate auditory 
 images. I can give my verbal images the timbre of my father's 
 voice, — but this only with difficulty, and the attempts are 
 often fruitless. A visual image of my father is an invariable 
 prerequisite. I know, for instance, that my father has often 
 employed the expression 'My boy' when conversing with me. 
 But I find no trace of an auditory memory of my father's voice 
 when I express the silent judgment, 'My father has often used 
 the phrase, "My boy." ' Even with the greatest pains I can- 
 not imagine the peculiarities of his voice. This is possible 
 only when I have a definite visual image of my father, and 
 imagine a specific occasion for his speaking." ^ 
 
 And again : 
 
 "Immediately after I have heard some one speak, I can 
 recall his words with the greatest clearness. But these fade 
 quickly, and usually no auditory memory remains. Similarly, 
 it is difficult for me to obtain an auditory memory of my own 
 voice. When I speak a word and attend especially to the 
 auditory impressions, I am able for some time afterward to 
 reproduce the acoustic image at will. But this ability dis- 
 appears, too, after a while; and all traces of sound are soon 
 lost in the imagery of movement." ^ 
 
 The above paragraphs make it clear that Dodge 
 is not entirely lacking in auditory imagery ; though 
 the imagery is obviously weak. Dodge gives it as 
 his opinion that the fulness and roundness of his 
 verbal images subsists not only in vibration-feelings 
 in the larynx and thorax, but also in "a kind of un- 
 localized, evaporated auditory imagery" that be- 
 
 1 Dodge, loc. cit., pp. 15-16. ^ Loc. cit., p. 17. 
 
THE VERBAL IMAGE 57 
 
 comes only in exceptional circumstances a clear and 
 independent reproduction. 
 
 Strieker, likewise, is not entirely destitute of audi- 
 tory memory. He is sometimes able to recall a 
 person's voice by first visualizing his figure, or by 
 clearly imagining the circumstances under which 
 particular words were spoken. The memory is then 
 of words as uttered upon a particular occasion, rather 
 than of words as having a specific meaning. 
 
 An important fact must be noted at this point: 
 In recalling the voice of a particular person, the audito- 
 moteur does not necessarily resort to pure auditory 
 imagery. Strieker's "open-mouth test" will show 
 that the labial and explosive consonants are as much 
 motor as ever. The characteristic timbre of the voice 
 is represented only in the vowel ; and it is this part 
 of the word that is mentally heard. The writer finds 
 that this is the case with his own imagery. He can 
 on rare occasions recall the peculiar pronunciation 
 that a certain Oriental friend accords to his name. 
 But introspection shows that he is himself mentally 
 pronouncing the word, and that the characteristic 
 quality of the remembered voice is present only in 
 the vowel of the last syllable. The case is similar 
 with the primary memory. The word is present as 
 an auditory-motor image ; the consonants are dis- 
 tinctly felt, but the characteristic auditory element 
 inheres only in the vowel. 
 
58 THE PSYCHOLOGY OF STAMMERING 
 
 From the foregoing arguments it should be clear 
 that the average person is an audito-moteur. His 
 verbal imagery is of the mixed type. When thinking 
 silently in words, he both hears them and feels them.^ 
 If his acoustic memory is strong, he may have a sound- 
 image of the entire word, and kinaesthetic images of 
 only the grosser muscular movements; i.e. chiefly 
 of the consonants. His verbal image will then have 
 a binary, or dual, form. For consciousness, however, 
 one image will be, as it were, superposed upon the 
 other, and the images will appear to the mind as a 
 unit — or, if introspection is keen, as a composite 
 image. If, on the other hand, the acoustic memory 
 is weak, there will be an auditory image of only the 
 vowel. The consonants and grosser muscular move- 
 ments of speech will be represented in kinaesthetic 
 imagery, and the verbal imagery will in actuality be 
 composite.^ In either case the presence of the audi- 
 
 * There appears to be also an auditory-motor musical memory. 
 Some people are unable to recall a tune without mentally humming 
 it, singing it, or playing it upon a musical instrument. The sounds 
 can be redintegrated only when they are associated with the kin- 
 aesthetic memory of specific movements. The movements are prob- 
 ably recalled first, the sounds being awakened by association. 
 
 2 Various phenomena indicate that the word is normally repre- 
 sented in the brain by a plurality of cells. One may, for instance, 
 remember the initial consonant of a word (in terms of feeling), but 
 be unable to recall the word in its entirety. One may interchange 
 the initial consonants of contiguous words and syllables {achoppe- 
 mevU syllabique), etc., etc. 
 
THE VERBAL IMAGE 59 
 
 tory image will be required for normal verbal thought 
 and normal oral expression. 
 
 The feeling-element of speech has in this discussion 
 been treated as exclusively kinaesthetic. This has been 
 done for the sake of simphcity. In reality, the feeling- 
 element does not comprise merely the consciousness of 
 muscular movement or muscular action, but it em- 
 braces in addition tactual sensations, — sensations of 
 contact, friction, and the hke. The fricatives, /, v, s, 
 th, etc., are as much tactile in their representation as 
 they are kinaesthetic. The matter is more readily un- 
 derstood by regarding the sensations rather than the 
 mental images. In pronouncing the letter /, for in- 
 stance, the only muscular movement involved (neglect- 
 ing respiration) is that of bringing the lower Hp into 
 contact with the upper teeth. In this act one is con- 
 scious of the contraction of the labial muscles ; but one 
 is also conscious of certain characteristic cutaneous 
 sensations. After the initial movement has been per- 
 formed, there is practically no muscular activity in the 
 articulative organs. There may be a sHght tension in 
 the muscles of the lower lip from which one could de- 
 rive kinaesthetic sensations ; but if the consonant is con- 
 tinuously produced, the more conspicuous sensations are 
 undoubtedly tactual. The tactual impressions in this 
 case consist of the sensation derived from the contact 
 of the upper teeth with the lower Hp, and the sensation 
 
6o THE PSYCHOLOGY OF STAMMERING 
 
 produced by the passage of the air through the labial 
 aperture. It is evident, then, that a continuous / — 
 since it occasions marked tactual sensations in actual 
 enunciation — must be mentally represented largely 
 in tactual terms. An / that is not continuously pro- 
 duced contains these sensations no less than one that 
 is prolonged ; there is a difference merely in duration. 
 Similar arguments can be adduced in support of the 
 tactual element in all the continuous consonants. 
 
 The explosive consonants involve a greater amount 
 of muscular activity ; but they contain, nevertheless, a 
 marked tactual element. Taking the letter h, for ex- 
 ample, we find that a tactual sensation is derived from 
 the contact of the two lips. As the labial pressure is 
 increased to resist the air-column, there is naturally an 
 increased muscular tension giving rise to kinaesthetic 
 sensations. But there is also an increased pressure 
 by the air-column upon the inner surfaces of the lips, 
 and this produces a characteristic tactual impression. 
 The explosive consonants, then, as well as the con- 
 tinuous consonants, give rise to tactual sensations, and 
 they are represented by tactual images in the mind. 
 
 There is no strict line of demarcation between 
 the kinaesthetic and tactual elements. Kinaesthetic 
 sensations may be regarded as tactual sensations from 
 muscular, tendinous, and articular surfaces. They 
 are internal tactual sensations, or tactual sensations 
 derived exclusively from the muscular system. 
 
CHAPTER IV 
 THE BRAIN 
 
 The brain comprises the cerebrum and the cere- 
 bellum (or little brain). The cerebellum Hes below 
 the cerebrum, in the posterior part of the cranium. 
 It stands in anatomical connection with the cerebrum 
 and spinal cord. The cerebrum is divided by the 
 median fissure into two more or less symmetrical 
 hemispheres. It presents a surface characterized by 
 numerous irregular furrows and convolutions. The 
 cerebellum contains three definite lobes, of w^hich 
 the median lobe is rudimentary. To the naked eye 
 the cerebellum presents a regular, laminate structure. 
 The great mass of the brain consists of white matter, 
 composed chiefly of fibres. There is a superficial 
 layer of gray matter, two or three millimeters thick. 
 This surface-layer — consisting chiefly of cells — 
 is called the cortex. 
 
 The principal fissures of the cerebrum are the median 
 fissure, the fissure of Sylvius, and the fissure of Ro- 
 lando. These last two, with the parieto-occipital 
 fissure, divide the external surface of the hemisphere ^ 
 
 1 In discussing the fissures and convolutions, one hemisphere is 
 taken for the sake of simplicity. 
 
 6i 
 
62 THE PSYCHOLOGY OF STAMMERING 
 
 into its four principal lobes. These are the frontal, 
 parietal, temporal, and occipital lobes, named after 
 the bones of the skull to which they lie contiguous. 
 
 The frontal lobe comprises the first, second, and 
 third ^ frontal convolutions,^ and the precentral 
 convolution, which lies just anterior to the Rolandic 
 fissure. The temporal lobe embraces the ventral 
 aspect of the hemisphere. It contains the first, 
 second, and third ^ temporal convolutions. The oc- 
 cipital lobe comprises the first, second, and third ^ 
 occipital convolutions, — in the posterior part of the 
 hemisphere. The parietal lobe lies posterior to the 
 fissure of Rolando. It contains the postcentral con- 
 volution, the superior parietal lobule, the supra-mar- 
 ginal gyrus, and the angular gyrus. 
 
 The mesial aspect of the hemisphere ^ displays the 
 marginal gyrus, the gyrus fornicatus, the hippo- 
 campal gyrus, the uncinate gyrus, and the quadilateral 
 and cuneate lobules. The island of Reil, another small 
 group of convolutions, is found at the bottom of the 
 fissure of Sylvius. 
 
 The gray cortex of the brain follows each of the 
 different folds and convolutions; thus the entire 
 surface of the brain is composed of a layer of cells. 
 
 The cells of the cortex are in direct connection with 
 the white fibres that compose the great mass of the 
 
 1 Also designated superior, middle, and inferior. 
 
 2 See Figure i. 'See Figure 2. 
 
THE BRAIN 
 
 63 
 
64 
 
 THE PSYCHOLOGY OF STAMMERING 
 
 P' 
 
 •I 
 
 a 
 
 •a 
 
 •c 
 
 B 
 o 
 
 M 
 tn 
 
 a 
 
 O 
 (14 
 
THE BRAIN 65 
 
 brain. The cell-body and its numer- ^'^'^^^^^^^Z'- 
 ous filaments and ramifications con- j, ^\, t'.S. -{^ 
 stitute a functional unit, known as a 
 neurone.^ The brain consists simply 
 of neurones, with the neuroglia — or 
 supporting tissue — and a rich supply hl.Wlp^'^rfV^k 
 of blood-vessels. The filaments pro- \'^j^^\^'fe^ 
 ceeding from the cell-body vary in 
 length from the merest fraction of a 
 millimeter to several feet, the longer 
 fibres, of course, extending beyond the 
 brain. The shorter filaments form 
 connections between the different cells 
 themselves (these are the association 
 fibres), while the longer fibres con- 
 vey stimuh from the sense-organs or 
 carry impulses to the muscles. The 
 fibres that convey the ingoing stimu- ^^'^i 'f ^*-">72 
 lus are known as sensory, or afferent, "C-'t^* **5t', ^'^'C 
 nerves. Those conveying the out- iV'**-:'iJ^i^*f*»?'i 
 going stimulus are known as motor, v"l:v^iii^^^;;Vi? 
 or efferent, nerves. f'^^^wl^i/^**, 
 
 1 Donaldson estimates that there are not less \ rM^^, J)^* 
 than three thousand million neurones in the \\ ^ S/" 
 central nervous system. (See "The Growth o^ '^ "i * U 4^V 
 
 the Brain.") ^'^ ^^V 
 
 Figure 3 represents the cells of the cerebral 
 cortex magnified 114 diameters (Farrier, after 
 Be van Lewis). Fig. 3 
 
 ^\^"^1 
 
66 THE PSYCHOLOGY OF STAMMERING 
 
 Thus there are three distinct classes of nerve-fibres, 
 — the association-fibres, the sensory fibres, and the 
 motor fibres. The association-fibres may be sub- 
 divided into long and short unilateral fibres, and 
 transverse fibres. The transverse fibres connect 
 convolutions in the opposite hemispheres.^ The long 
 unilateral fibres unite cells in different convolutions of 
 the same hemisphere. The short fibres connect cells 
 that are practically contiguous. 
 
 There is a decussation of the sensory and motor 
 nerve-fibres, so that the left hemisphere of the brain 
 stands in connection with sense-organs and muscles 
 of the right side of the body, while the right hemi- 
 sphere of the brain is connected with the left side of 
 the body. There is an exception in the case of the 
 olfactory tracts. The case of vision is somewhat 
 anomalous. The left half of each retina is in con- 
 nection with the left hemisphere of the brain, while the 
 right halves of the retinae are connected with the right 
 hemisphere. Thus an injury to the visual area in the 
 left cortex results in bHndness to the left halves of 
 both retinae; consequently there is an obliteration 
 of the right field of vision. 
 
 As already stated, the muscles of one side of the 
 body are connected with the hemisphere of the op- 
 posite side. The right hand is moved through the 
 
 ^ The principal band of transverse fibres is known as the corpus 
 callosum. (See Fig. 2.) 
 
THE BRAIN 67 
 
 activity of cells in the left cortex; the left hand is 
 moved through the activity of cells in the right cortex. 
 This principle holds good for movements that are 
 executed unilaterally. Movements that are invari- 
 ably executed bilaterally are represented in only one 
 hemisphere of the brain.^ This is true of the articu- 
 lative movements concerned in speech. In right- 
 handed persons, speech-movements are initiated from 
 the left hemisphere. In left-handed persons, they are 
 initiated from the right hemisphere. 
 
 This brings us to the matter of cerebral locaHzation. 
 It is found that the brain-cells controlling particular 
 muscles of the body or subserving particular sense- 
 organs are not scattered promiscuously throughout 
 the cortex, but are localized in fairly well-defined 
 brain-areas or convolutions. This fact has been 
 demonstrated in a variety of ways. It has been 
 established by experiments performed upon animals 
 — usually monkeys. After the cortex has been ex- 
 posed, different areas are electrically stimulated. 
 It is found that stimulation of definite areas of the 
 brain results in the contraction of definite muscles. 
 Certain areas control the movements of the leg; 
 others control the movements of the arm. These 
 areas can be subdivided, and definite localities assigned 
 
 ^ This statement is capable of qualification. To avoid complica- 
 tion and irrelevant discussion the principle is stated without its 
 restrictions. 
 
68 THE PSYCHOLOGY OF STAMMERING 
 
 for the control of the shoulder, forearm, hand, index 
 finger, thumb, etc. The movements occur, of course, 
 on the opposite side of the body. When the stimulus 
 is appKed to the area that controls the muscles of the 
 face, the resultant movements are generally bilateral. 
 The sensory areas have been determined by extirpa- 
 tion of different portions of the cortex. Excision of the 
 occipital areas leads to bHndness ; destruction of the 
 temporal areas induces loss of hearing. Ablation of 
 a motor area, of course, results in paralysis of the re- 
 lated muscles. 
 
 Investigations upon animals have been confirmed 
 by experiments performed upon human beings when 
 the cortex has been exposed by injury. The motor 
 areas can be determined by electrical stimulation. 
 An injury or tumor in these same areas results in 
 paralysis. An injury in one of the sensory centres 
 results in bhndness, deafness, or in loss of the images 
 of sight or hearing, according to the seat of the damage. 
 
 The site of the sensory centres is further indicated 
 by cerebral atrophy. If a child is born blind or deaf, 
 his visual or auditory brain-centre never becomes 
 functionally mature. In many cases atrophy or 
 softening takes place in the centre affected. The loca- 
 tion of the degenerated area indicates, of course, the 
 seat of the sensory centre 
 
 The site of the different cerebral centres has like- 
 wise been demonstrated by the embryonal method. 
 
THE BRAIN 69 
 
 Different fibres acquire their myelin sheaths at dif- 
 ferent periods; thus they can be traced from the 
 peripheral senses-organs to their termination in the 
 cortex. 
 
 The general motor area of the brain is situated in 
 the Rolandic region. Figure 4 shows on the human 
 brain the various subdivisions of the motor area as 
 ascertained by Beevor and Horsley through experi- 
 ments on the bonnet monkey. The researches of 
 some other investigators seem to indicate that the 
 true motor area lies anterior to the Rolandic fissure, 
 and that the region posterior to the fissure embodies 
 the corresponding sensory areas for the reception of 
 tactile, thermal, kinaesthetic sensations, etc. The 
 opinion of physiologists is by no means unanimous on 
 this point, and it is held by many that the region on 
 both sides of the Rolandic fissure is sensory-motor, 
 rather than motor on one side and sensory on the 
 other. Investigation is difficult, since destruction of 
 the sensory regions impairs the motor functions. 
 Fortunately this matter does not vitally concern the 
 discussions of the present monograph. 
 
 It will be noticed that the centre for the control 
 of the oral and vocal mechanism is at the foot of the 
 precentral and postcentral convolutions. In the 
 orang-outang this centre appears to be confined to 
 the precentral convolution. A similar localization is 
 made by most physiologists in regard to human beings. 
 
70 
 
 THE PSYCHOLOGY OF STAMMERING 
 
 -§ 
 
 
 
 O 
 > 
 
 W xi 
 
 •-I ti 
 
 o 
 o 
 
 (S4 
 
THE BRAIN 71 
 
 The subcentre for the oral articulative mechanism is 
 supposed to He posterior to that for the vocal mechan- 
 ism. The motor fibres from the speech-centre pass 
 to the motor centres in the medulla oblongata/ these 
 centres being in direct connection with the organs of 
 speech. 
 
 The region of the uncinate gyrus and hippocampal 
 gyrus is regarded as the site of the olfactory and 
 gustatory centres. The area for the reception of 
 visual impressions is located in the occipital lobe, 
 chiefly in the neighborhood of the cuneate lobule. 
 The auditory area is found in the temporal lobe, espe- 
 cially in the first and second convolutions. Each of 
 these ''internal sense-organs" ^ stands connected with 
 the peripheric sense-organ of the opposite side of the 
 body. Both hemispheres of the brain are active dur- 
 ing the reception of simple sensations of sight, hearing, 
 etc. 
 
 The memory-centres ^ are remarkable in that they 
 are located in the left hemisphere of the brain in 
 right-handed persons, and in the right hemisphere 
 in left-handed persons. The reason for this phenome- 
 non and for dextrality is somewhat of a biological 
 mystery. Bastian has found that the specific gravity 
 
 ^ The bulb of the spinal cord, which lies within the cranium. 
 
 2 With the exceptions stated on page 66. 
 
 2 By a memory-centre is meant a centre presiding over a partic- 
 ular type of mental imagery. The term does not imply that the 
 centre is necessarily devoid of sensory function. 
 
72 THE PSYCHOLOGY OF STAMMERING 
 
 of the cortical matter of the frontal, parietal, and 
 occipital regions is greater in the left hemisphere than 
 in the right. This phenomenon is probably in the 
 nature of effect rather than cause. Ogle has sug- 
 gested that dextrahty is occasioned by certain 
 pecuHarities in the mode of development and distri- 
 bution of the left and right carotid arteries. A 
 freer blood supply to the left hemisphere is invoked 
 as the cause of this hemisphere's earlier development.^ 
 But if a freer blood supply to the left hemisphere were 
 to account for its earHer development, it would not 
 necessarily follow that the earlier development of 
 the hemisphere explains its exclusive control of 
 memory. 
 
 The confinement of the memory-centres to one 
 hemisphere probably renders possible a greater rich- 
 ness of associations; thus the phenomenon might 
 perhaps be explained by natural selection. In any 
 case, the fact remains that the memory-centres are 
 restricted to the left hemisphere in right-handed 
 persons, and to the right hemisphere in left-handed 
 persons. 
 
 The site of the memory-centres can be designated 
 with considerable accuracy. This is especially true 
 of the memory-centres concerned in speech, for the 
 slightest injury to a speech-centre at once gives rise 
 
 ^ In many left-handed persons a freer blood supply has been found 
 to obtain for the right hemisphere. 
 
THE BRAIN 
 
 73 
 
 to characteristic symptoms. The auditory verbal 
 memory is subserved by the posterior two-thirds of 
 the first temporal convolution {A. V. in Figure 5). 
 The anterior third of this convolution is generally 
 regarded as the seat of the musical memory. The 
 
 Fissure of Kolando 
 
 Sylvian 
 
 Fissure 
 
 Fig. 5. — Diagram showing the approximate site of the principal memory- 
 centres of the brain (after Bastian). G. M., graphic-motor centre; K. V., 
 kinaesthetic verbal centre ; G.A. C, general auditory centre ; A. V., auditorj' 
 verbal centre ; G. V. C, general visual centre ; V. V., visual verbal centre. 
 
 second temporal convolution is less important; it is 
 subservient (probably with some assistance from the 
 first temporal convolution) to the memory for ordi- 
 nary physical sounds. The kincEsthetic verbal memory 
 is located in the posterior part of the third frontal 
 convolution {K. V. in Figure 5). The kinaesthetic 
 
74 THE PSYCHOLOGY OF STAMMERING 
 
 verbal centre is known as '^Broca's convolution."^ 
 The graphic-motor centre, the centre in which are 
 stored kinaesthetic images of writing-movements, is 
 generally assigned to the posterior part of the second 
 frontal convolution {G. M. in Figure 5). This 
 localization is questioned by some investigators.^ 
 The visual verbal memory — the memory for printed 
 and written words — is located in the angular gyrus 
 (F. V. in Figure 5). The general visual centre — 
 for the memory of concrete objects — occupies the 
 adjacent regions of the occipital lobe.^ 
 
 It will be noticed that the visual memory-centre is 
 anomalous in that it does not coincide with the centre 
 for the reception of visual impressions, — the primary 
 visual centre. There appears to be no doubt, how- 
 ever, concerning the location of these two centres. 
 A lesion in the cuneate lobule results in hemianopsia, — 
 
 ^ Broca was the first to point out the intimate connection of this 
 convolution with the function of speech. Broca's convolution was 
 at first regarded as a unitary speech-centre. 
 
 2 The centre for writing-movements is undoubtedly identical 
 with that for hand-movements. We know that kinaesthetic images 
 of writing-movements and of hand-movements exist. The psycho- 
 logical data are beyond question. The exact site of the brain-centre 
 is a matter of secondary importance ; hence it would be useless to 
 discuss the merits of this allocation. 
 
 ^ It must not be supposed that the position of each brain-centre 
 is strictly delimited. Along the borders there must necessarily be 
 considerable interblending ; hence the adjunctive regions belong 
 equally to the two adjacent centres. A lesion in these regions would 
 affect both centres slightly, and neither of them radically. 
 
THE BRAIN 75 
 
 blindness in one half of the visual field ; but if the 
 lesion is limited, it does not necessarily affect the 
 visual memory. On the other hand, an injury to 
 the angular gyrus and its adjacent region obhterates 
 the visual memory, yet leaves physical sight unim- 
 paired. The patient then sees quite clearly, but is 
 unable to recognize objects and unable to think in 
 terms of sight. These facts seem to indicate that 
 there are discrete centres for the reception and re- 
 tention of visual impressions. — A Hke condition may 
 obtain for the other senses. There is some slight 
 evidence for it in the case of audition. 
 
 The kingesthetic memory-centres are anterior to 
 the fissure of Rolando. This fact indicates that the 
 somaesthetic area is not confined to the region posterior 
 to the fissure of Rolando or that the sensory and 
 memory centres in this instance do not coincide. 
 
 Large portions of the cortex seem to be neither 
 sensory nor motor. They are regarded as associa- 
 tion areas. The cerebellum is not an organ of con- 
 scious intelligence. It is intimately connected with 
 the maintenance of equilibrium, and its function seems 
 to be in general a coordinating one. 
 
 From the foregoing discussion it is manifest that 
 we have not only memories rather than memory, 
 but also brains — or brain-centres — rather than a 
 brain. We have an auditory brain, a visual brain, 
 
76 THE PSYCHOLOGY OF STAMMERING 
 
 a kinaesthetic brain, and so on. These different 
 brains, or brain-centres, may have different degrees 
 of activity, resulting in different degrees of vividness 
 in the various kinds of mental imagery. Different 
 brain-centres participate in different acts of percep- 
 tion and conception. In some mental processes, 
 all the brain-centres may be active; in others, per- 
 haps only one or two. 
 
 In the reception of a simple sensation, the activity 
 of only one brain-centre is necessary.^ There are 
 no associations; the mental process is complete 
 when the sensation has become enregistered in the 
 brain-cells. With perception or conception the mat- 
 ter is different; the stimulus must travel from one 
 centre to another. To take Charcot's classical 
 illustration of the child and the bell (and to consider 
 first the manner in which the various elements of 
 the percept or concept are established) : ^ — The child 
 takes the bell into his hands and receives a set of 
 tactual sensations, the sensory stimulus travelling 
 along the afferent nerves to the somaesthetic area of 
 the brain and impressing itself in the cortex. At the 
 same time the child sees the bell : ether waves affect 
 the retina of the eye, and the afferent current travels 
 along the optic nerve and effects chemical changes 
 in the cells of the optic lobe. As the child hears the 
 
 1 The right hemisphere is neglected for the sake of simplicity. 
 
 2 See Ballet, "Le langage int6rieur et I'aphasie," 2d ed., pp. 6 ff. 
 
THE BRAIN 77 
 
 bell, air-vibrations impinge upon the drum of the ear, 
 and the stimulus is conducted along the auditory 
 nerve to the auditory brain-centre, where the impres- 
 sion is enregistered. Kinaesthetic impressions are 
 similarly enregistered in the cortex. Thus there are 
 at least four brain-centres subserving the child's 
 concept of the bell even before he has learned to talk. 
 And now for the act of perception. When the child 
 sees the bell on some subsequent occasion, the ap- 
 pearance of the object arouses memory-images of 
 its sound and of the feehng derived from handhng 
 it.^ The excitation travels from the primary visual 
 centre to the secondary, or memory, centre ; whence 
 it radiates to the auditory, tactile, and motor memory- 
 centres. If one of these centres should be impaired, 
 or if a set of association-fibres should be severed, the 
 act of perception would remain incomplete. With the 
 auditory perception the process is similar. Cells in 
 the auditory centre are first excited ; then the stimu- 
 lus is diffused into the visual, tactile, and kinaesthetic 
 centres; and the sound of the bell arouses mental 
 images of its appearance, feehng, etc. If the child 
 were to feel the bell in the first place, the tactual 
 sensation would (by this process of irradiation) arouse 
 mental images in the auditory and visual centres, 
 and the perception would be complete. 
 
 ^ With a young child several repetitions of the experience would 
 be necessary to establish the associations. 
 
78 THE PSYCHOLOGY OF STAMMERING 
 
 Obviously there are numerous different doors 
 through which the percept can be aroused. The bell 
 may be visually perceived as one catches sight of it ; 
 it may be tactually perceived as one grasps it in the 
 dark ; and it may be auditorily perceived as one hears 
 it in another part of the house. In any one of these 
 cases the bare sensation would be practically meaning- 
 less if the stimulus were not to travel beyond the 
 '' receptive" centre and arouse the associated mental 
 images. 
 
 Taking, for further illustration, the percept of an 
 orange, we have two new classes of sensations that 
 may arouse associated images. The orange may be 
 perceived if it is merely smelled. It may be per- 
 ceived equally well by taste. The mental process 
 becomes a perception, rather than a sensation, when 
 the stimulus travels from the gustatory or olfactory 
 centre to the memory-centres for visual and tactual 
 impressions. 
 
 It is evident that the conceptual and perceptual 
 processes are analogous. The nucleus of the percept 
 is the sensation occasioned by the stimulus to the 
 peripheric sense-organ : the activity of the cortical 
 cells is instigated from without. The nucleus of the 
 concept is a mental image — produced by the idio- 
 activity of the memory-cells. An illusion — a false 
 perception — is due to the fact that the excitation trav- 
 erses inappropriate fibres and reaches an inappro- 
 
THE BRAIN 79 
 
 priate cell. Illusions occur most frequently during ex- 
 pectancy, — that is, when particular memory-cells are 
 unusually active or '^excitable." It seems as though 
 an efferent current comes out to meet an afferent 
 current and diverts it from its proper course. In 
 hallucination (as distinguished from illusion) the 
 memory-cell reaches plenary activity without external 
 stimulation. The mental image is then mistaken for 
 a sensation. 
 
 Concepts and percepts are further complicated by 
 the introduction of language. In the cases cited 
 above, the word hell or orange is introduced as an 
 integral part of the concept. When the word is 
 heard or thought, the various associated images arise 
 in the foreground of consciousness or appear in the 
 ''fringe." Conversely, if the bell or orange is seen, 
 or is thought of in any form of mental imagery, its 
 name is aroused by association. 
 
 WylKe performed an interesting experiment to 
 illustrate the mental processes in perception,^ — using 
 a number of children as subjects. He called one boy 
 into the room and showed him an apple lying upon 
 the table. The boy was asked to state what the ob- 
 ject was. The answer came at once, ''It is an apple." 
 The second child was permitted to smell the apple after 
 his eyes had been bandaged. He likewise named the 
 object immediately. The third boy had a piece of 
 
 ^ "Disorders of Speech," pp. 227 ff. 
 
8o THE PSYCHOLOGY OF STAMMERING 
 
 an apple placed in his mouth. The fourth had an 
 apple placed in his hands. Both of them named the 
 object correctly. With other subjects the apple was 
 pared close to the ear, so that the sound could be 
 plainly heard. Many of them recognized the sound. 
 The final experiment was an appeal to the kinaesthetic 
 sense. An artificial apple, made of metal, was placed 
 upon the table. The imitation could not be detected 
 by the eye, but the deception was immediately 
 recognized when the apple was taken into the hands. 
 
 In these different acts of perception the word- 
 image apple may have been directly aroused by the 
 sensation, or it may have been indirectly invoked 
 through one of the awakened mental images. In any 
 case the word is aroused by the overflow of the mental 
 "current" into the adjoining brain-centres. The 
 process is dependent upon the integrity of the brain- 
 cells and fibres concerned. It is found in some 
 pathological cases, where certain brain-fibres have been 
 severed, that a person may recognize an object placed 
 in one hand though he cannot recognize it when it is 
 placed in the other. The break in the fibres furnishes 
 a check to the mental current, so that it cannot pass 
 into the adjoining brain-centres and awaken the 
 associated mental images.^ 
 
 In the case of the congenitally blind or congenitally 
 deaf, whole brain-centres are ruled out of the per- 
 
 1 In such cases the interruption is probably in the transverse fibres. 
 
THE BRAIN 8l 
 
 ceptual and conceptual processes. The mental current 
 can never enter these areas to awaken visual or au- 
 ditory ideas. If the person is both blind and deaf, 
 the mental current is restricted almost exclusively to 
 the anterior portion of the brain. If the visual or 
 auditory areas become damaged later in life, when the 
 person is dependent upon his images of sight and hear- 
 ing, mental ef&ciency is greatly impaired. 
 
 In the foregoing discussion the word-image has 
 been treated as though it were a unitary image that 
 could be aroused through the activity of a single 
 brain-centre. Such may be the case in rare instances, 
 — in the typical audile, for instance. But, as we 
 have seen in the preceding chapter, the word-image 
 is usually complex, and its appearance in conscious- 
 ness often requires the activity of a number of dif- 
 ferent centres. 
 
 We may consider first the simple memory-image of 
 the spoken word uncomplicated by visual images of 
 written or printed words or by kinaesthetic images 
 of writing-movements. In this case the word-image is 
 subserved by the kinaesthetic verbal centre and the 
 auditory verbal centre {K. V. and A. F. in Figure 5). 
 With the articulo-moteur the activity may be limited 
 in silent thought almost exclusively to the centre 
 K. V. This person feels his words when thinking 
 them. When the activity begins in ^. F. (as he is 
 
82 THE PSYCHOLOGY OF STAMMERING 
 
 listening to the speech of another person) there is an 
 overflow into K. V., and he mentally articulates the 
 words as he hears them. With some motor-minded 
 persons the activity of K. V. appears to be indis- 
 pensable for silent thought and the interpretation of 
 spoken words. A lesion in the kinaesthetic verbal 
 centre then impairs silent thought and renders the in- 
 terpretation of spoken language extremely difficult. 
 
 With the average person the activity of both K. V. 
 and A. F. is essential for silent thought. The more 
 prominent articulative movements are mentally felt, 
 and the whole word — or simply the vowel — is at 
 the same time mentally heard. The activity com- 
 mences in K. V. and flows into A . V. Frequently the 
 mental process remains incomplete. One remembers 
 the letter that begins a particular word without being 
 able to recall the rest of it. (There are no visual 
 images present: the initial articulative movement 
 is simply felt.) It seems that the neural current is 
 checked in its passage from K. V. to A. V., or that the 
 cells in ^. V. are abnormally torpid.^ 
 
 When the auditory tendency predominates, the 
 activity may perhaps begin in ^. V. and overflow 
 to some extent into K. V. This is an inverted order 
 of association, and probably does not usually occur. 
 When the image is initiated in the centre A. F., it 
 
 ^ The idea of a neural current is more or less a working hypothesis. 
 It is not known exactly what takes place in the brain during thought. 
 
THE BRAIN 83 
 
 has, without the addition of the motor image, the 
 '^fulness" and ''roundness" of a mental word. 
 When the image is initiated in K. V., it is often at- 
 tenuated till A. V. has supplied the mental sound. 
 Conjoint activity of the two centres is necessary in 
 the latter case, but not in the former. When the 
 activity begins in ^ . F. , the person is probably a pure 
 audile. 
 
 With the educated person the kinsesthetic and 
 auditory verbal centres are supplemented by two 
 centres connected with the faculty of reading and 
 writing. These are the visual verbal centre, pre- 
 siding over images of printed and written words, and 
 the graphic-motor centre, presiding over the kinass- 
 thetic memories of writing-movements (represented 
 respectively as V. V. and G. M. in Figure 5). The 
 centre F. V., in the angular g3Tus, plays a prominent 
 part in verbal representation with eye-minded people. 
 The activity begins in F. F and flows into K. V. and 
 A . F. This happens when the person reads his words 
 from an imaginary printed strip, or sees them before 
 him in any form of visual imagery. The activity 
 may in rare instances be confined to F. F. ; in this 
 case the visual image of the word does not arouse the 
 image of the spoken word. This happens with the 
 deaf-mute that has learned to read and write, but not 
 to speak. The associations of meaning are attached 
 directly to the visual image as a nucleus. With all 
 
84 THE PSYCHOLOGY OF STAMMERING 
 
 persons the activity commences in V. V. during the 
 act of reading ; it then passes into K. V. and A. F. as 
 the printed word arouses the memory of its spoken 
 correlate. 
 
 With the visile, the auditory impression of a word 
 frequently awakens the associated visual verbal 
 image. In this case the activity flows from ^. V. into 
 V. V. : the stimulus passes from cells in the first tem- 
 poral convolution and along the associational fibres into 
 the angular gyrus, where the related cells are excited. 
 If the words are to be written from dictation, the 
 stimulus passes on to the graphic-motor centre, and 
 kinaesthetic images of the necessary hand-movements 
 are provoked. 
 
 The graphic-motor centre, unHke the three other 
 verbal centres, plays no prominent part in verbal 
 thought. The reason for this is undoubtedly found in 
 the complexity of the imagery that it subserves. The 
 graphic-motor image would, by its duration, materi- 
 ally impede the thought-processes. The other verbal 
 images can arise instantaneously, and for this reason 
 are better adapted to verbal thought. The graphic- 
 motor image does, however, frequently arise in the 
 motile during moments of preoccupation. This is 
 especially true of the subject that spends much of his 
 time in writing. As he hears a word to which he is 
 paying no particular attention, or thinks a word in 
 a casual way, he may find himself mentally penning 
 
THE BRAIN 85 
 
 the letters that compose it. This phenomenon is 
 due to the passage of the stimulus into the centre 
 G. M. The present writer, in whom motor images 
 are signally strong, frequently experiences a curious 
 obtrusion of the kinaesthetic images. As a word rises 
 in the mind during a moment of abstraction, he fre- 
 quently finds himself mentally tapping the word out 
 on a typewriter. There is seldom present a visual 
 image of the keyboard. When it appears, it is rudi- 
 mentary to the last degree. There is no mental 
 imagery of sound. The overflow is confined to the 
 hand-movement centre. If it passes to the visual 
 centre, the current is either too weak or the cells are 
 too torpid to permit the arousal of a clear visual image. 
 If the current passes to the auditory centre, it is again 
 too weak, or it meets with insuperable inertia.^ 
 
 1 In the case of the writer, the visual images are usually vestigial 
 or schematic. Auditory images are practically non-existent. 
 
CHAPTER V 
 
 THE RELATION BETWEEN MENTAL IMAGERY AND 
 VOLUNTARY SPEECH 
 
 What is the cause of a voluntary muscular move- 
 ment? Exactly what is it in the mind that directs 
 such a movement as lifting the arm, for instance? 
 Why is the act invariably the appropriate one, and 
 why does one not protrude the tongue or suddenly 
 sit down instead of executing the arm-movement in- 
 tended ? The opinion that finds the widest acceptance 
 among psychologists is that the immediate provo- 
 cative of a voluntary movement is a mental image of 
 the effect that the movement will produce. This 
 effect may be the feeling of the movem.ent itself, or 
 the impression of certain results that the movement 
 produces indirectly. 
 
 The memory of the direct effect James calls the 
 resident image} It is the tactile memory of the 
 different cutaneous sensations, and the kinaesthetic 
 memory of tendinous strain, contraction of the mus- 
 cles, movement of the joints, etc. The indirect effect 
 of the movement may be the sound of a bell, a note 
 
 1 "Principles of Psychology," Vol. II, pp. 488 £f. 
 86 
 
MENTAL IMAGERY AND VOLUNTARY SPEECH 87 
 
 from a violin ; it may be a tactile sensation as one 
 plunges the hands into water, an olfactory sensation 
 as one lifts a rose to the nostrils, or a gustatory sensa- 
 tion as one raises a cup of coffee to the lips. This 
 resultant sensation James calls the ''remote" effect. 
 The memory of it is the remote image. Apparently, 
 either the resident or the remote image may excite 
 a muscular movement. It is probable, however, 
 that when the remote image appears to be the sole 
 instigator of the movement, the resident image is 
 really sandwiched in between the remote image 
 and the movement executed. It would be quickly 
 swamped by the kinaesthetic sensations. 
 
 Kinaesthetic images have a remarkable propensity 
 for self-expression. With many persons they give 
 rise to incipient movements. Thus we see the per- 
 son that moves the lips while reading or thinking 
 intently, and the person that thinks aloud. These 
 movements might be ascribed to the remote as well as 
 to the resident image, but it is easy to show that the 
 resident image is always straining at the leash and 
 endeavoring to express itself in movement. Let the 
 reader place an arm upon the table, and rigidly con- 
 tract its muscles. Then let him endeavor to obtain 
 in memory a clear feeling of the arm's relaxation. 
 Any degree of success is immediately accompanied 
 by a diminution in the tension of the muscles. Let 
 the reader then place both arms upon the table, and 
 
88 THE PSYCHOLOGY OF STAMMERING 
 
 firmly contract the muscles of the right arm while 
 relaxing the muscles of the left. Let him then attend 
 to the feehngs in the rigid arm and the relaxed arm 
 alternately. As he attends to the contraction of the 
 muscles in the right arm, the muscles of the left tend 
 to contract Hkewise. As he transfers his attention 
 to the left arm in order to effect its relaxation, the 
 tension of the right arm diminishes. In this case the 
 sensory impressions play the part that is usually 
 taken by kinsesthetic images. 
 
 Muscle-reading (the "wilHng game") is based upon 
 this propension of the kinaesthetic image for express- 
 ing itself in movement. The performance is usually 
 represented as mind-reading. The performer under- 
 takes to find, while blindfolded, a certain object that 
 has been hidden in the room. He takes the hand of 
 the "medium" (who of course knows where the object 
 is hidden), and proceeds to ''receive" the thought, 
 the rest of the company meanwhile concentrating 
 intently in order to render ''telepathic" assistance. 
 The medium is exhorted to "think hard," and so on. 
 In a few minutes the hidden object is found. What 
 happens is that the performer reads the little pulls 
 and tugs of the "medium's" hand, which the latter 
 is quite unconscious of making. As the "medium" 
 endeavors to concentrate his thought, his kinaesthetic 
 images become more intense or come more to the 
 foreground of consciousness, and without his knowl- 
 
MENTAL IMAGERY AND VOLUNTARY SPEECH 89 
 
 edge they find expression in incipient movements. 
 Frequently these movements are so conspicuous that 
 the veriest novice could not fail to find the hidden ob- 
 ject. He is, in fact, led to the hiding-place. Usually, 
 of course, the movements are inchoate ; but the ex- 
 perienced muscle-reader finds them sufficiently con- 
 spicuous for his purpose. 
 
 The resident kinaesthetic images are undoubtedly 
 the sole mental cues for the grosser muscular move- 
 ments. For the more delicate muscular movements 
 — those involved in whistling, singing, speaking, 
 etc. — the remote images cooperate. In the deaf 
 or bhnd, or in those that are both deaf and blind, 
 many of the remote images are lacking. The con- 
 genitally deaf learn to speak by feeling in the same 
 way that the congenitally blind learn to write by 
 feeling. The mental cues are in each case resident 
 rather than remote.^ 
 
 *The question naturally arises as to how the first movements 
 come to be performed in order that the resident images may be 
 established. The answer is found in the biological principle (ex- 
 pressed as the dynamogenic law) that living matter tends to convert 
 a sensory stimulus into a motor response. The child's earliest 
 movements are purely involuntary : he is nothing more than a pas- 
 sive spectator of what is going on. The earliest random-spontaneous 
 movements are generally bilateral ; they are the kicking of the legs, 
 and the waving of the arms. Later comes vocal play, — cooing, 
 babbling, etc. (usually prompted by- feelings of bodily comfort). 
 The resultant images are enregistered in the mind, and the child is 
 later able to perform, voluntarily, movements that were at first 
 
90 THE PSYCHOLOGY OF STAMMERING 
 
 The question now suggests itself as to whether or 
 not one has any direct control of the emission of the 
 motor current. The most natural conception of the 
 matter is that the outgoing current is actually felt, 
 and that its discharge is under the direct control of 
 the will. It will be pretty generally conceded that 
 the motor current must be sentient if its emission 
 is to be voluntarily directed. But is the motor 
 current sentient? The current exists beyond a 
 doubt, but that its discharge is actually felt is 
 denied by many competent psychologists. What 
 is usually mistaken for the feeling of innervation 
 is nothing more than the kinaesthetic sensations — 
 the feehngs from the muscles, tendons, articular 
 surfaces, etc. 
 
 That these feelings are afferent rather than efferent, 
 
 spontaneous. "It follows from this that voluntary movements 
 must be secondary, not primary functions of our organism," (James, 
 "Psychology," Vol. II, p. 487.) These earlier movements of the 
 child are, of course, elementary. When he has gained control of his 
 legs, arms, and fingers in the manner described, his further move- 
 ments are in the nature of combinations of these elementary move- 
 ments. The child's operations are henceforth voluntary, but for 
 many years he progresses very largely by trial and error. 
 
 All of the bodily movements are not necessarily random-spon- 
 taneous in their inception. Many of the earliest movements are 
 externally impressed upon the limbs. 
 
 It is obvious that but for memory the child would remain an 
 organism responding to external stimuli. With memory, he is 
 able to respond to internal stimuli; i.e. he is able to effect "volun- 
 tary" movements. 
 
MENTAL IMAGERY AND VOLUNTARY SPEECH 91 
 
 is evident from the fact that one has an exact appre- 
 ciation of any movement that is externally impressed 
 upon the limbs. There can be no feeHng of innerva- 
 tion in this case ; yet the sensations do not differ in 
 quaHty from those accompanying a voluntary move- 
 ment. Furthermore, accurate discriminations of 
 weight can be made when the muscles of the arm are 
 made to contract artificially by means of an electrical 
 stimulus (Bastian). There is no motor current pres- 
 ent, yet the amount of the muscular contraction 
 can be accurately determined. It is clear that the 
 feeHng of effort and the supposed innervation-feeHng 
 must in this case be purely afferent. 
 
 It will be noticed that these feehngs inhere in the 
 muscles actually participating in the movement. 
 Hence, if the feeling emanates from the outgoing 
 current, it must be felt along the path of its discharge. 
 This being the case, it should be possible to trace the 
 course of the current through every nerve that it 
 traverses. The experiment of contracting the muscles 
 of the arm or leg will show that all consciousness of the 
 movement comes exclusively from the limb affected. 
 It is impossible to trace the motor channels through 
 the spinal cord, for instance. Hence one must con- 
 clude that only the ingoing current is felt. 
 
 The argument might be advanced that, even if 
 the motor current is not felt in the path of its dis- 
 charge, its emission is distinctly felt and controlled 
 
92 THE PSYCHOLOGY OF STAMMERING 
 
 at its source. Introspection refutes the argument. 
 There are many fugitive sensations that might be 
 mistaken by the untrained psychologist for this 
 feehng of the effort of the will. Such, for instance, 
 are sensations from the contraction of the brow, the 
 tension of the scalp muscles, the occlusion of the 
 glottis, etc. But when these sensations are eliminated, 
 nothing further remains. The only feehngs dis- 
 coverable are those in the muscles, tendons, etc. 
 It is impossible even to tell in which hemisphere of 
 the brain the motor cells reside. 
 
 There is another cogent argument against these 
 innervation-feelings. There is no conscious inner- 
 vation in reflex, automatic, and secondary-automatic 
 acts. The acts simply perform themselves in re- 
 sponse to the appropriate stimulus. In most cases 
 the innervation is altogether beyond the control "of 
 the will. Yet the secondary-automatic acts were 
 at first voluntarily performed. If sentient inner- 
 vations exist, we must suppose them to have been 
 present when the movement was still voluntary. 
 But in some mysterious way they have reHnquished 
 their function, and insentient innervations have re- 
 placed them. The existence of such a condition of 
 affairs seems improbable. 
 
 The import of the foregoing arguments is that the 
 motor current is not sentient, — that it is not felt 
 in the path of its discharge and that it is not felt at 
 
MENTAL IMAGERY AND VOLUNTARY SPEECH 93 
 
 its source. It is impossible to suppose that the inner- 
 vation-current can be insentient, and yet be under 
 the control of the will. Consciousness cannot con- 
 trol that of which it is unable to take cognizance. 
 And if we suppose that the will is in any way able 
 to emit the motor current, we must concede that the 
 will is a physical force ; whence we find ourselves 
 in conflict with the law of Conservation of Energy. 
 The attempt to compromise by supposing that the 
 will does not discharge the current, but merely con- 
 trols it, leads to the same dilemma : a force can be 
 controlled only by a force. 
 
 It is evident, then, that there can be no direct 
 control of the efferent current. Muscular movements 
 are controlled indirectly^ — by attention to the results 
 they produce. The non-psychologist may find it 
 difficult to subscribe to this thesis, but his acceptance 
 or rejection of it need not affect his attitude toward 
 later discussions. If he holds that the discharge is 
 voluntary, he must admit that its purpose is foreseen. 
 To admit that the purpose is foreseen is to admit that 
 the nature of the act is determined by antecedent 
 mental images. Thus the image remains paramount, 
 whatever views be held on innervation. The hegem- 
 ony of the mental image may, then, be regarded as 
 established. 
 
 The subject of indirect control — through the 
 mental image — need not be discussed at length. 
 
94 THE PSYCHOLOGY OF STAMMERING 
 
 Whatever views be held concerning the fiat — the 
 decision to act — the admission must still be made 
 that the mental imagery alone determines the nature of 
 the performance. With this point granted, we can 
 return to the subject of speech. 
 
 Our task is to ascertain the relative importance 
 of the kinaesthetic and auditory imagery in the initia- 
 tion of oral speech. It can be shown at the outset 
 that the kinaesthetic centre can in some cases assume 
 the sole directive function in oral speech, just as it 
 can assume the sole direction of verbal thought. 
 In the congenitally deaf that have acquired the mas- 
 tery of language, speech must be evoked almost 
 exclusively by kincesthetic cues. Some assistance 
 may be derived from visual images, but auditory 
 images are out of the question. In the case of the 
 deaf-bhnd Helen Keller, both visual and auditory 
 images are excluded, and speech is initiated ex- 
 clusively by images of feeling. Among persons not 
 deprived of any of the senses, we find a few that 
 have practically no auditory memory. It is evident 
 that they must resort to motor cues for the instiga- 
 tion of oral speech. Occasionally one of these '*ar- 
 ticulo-moteurs " suffers an injury to the auditory 
 verbal centre, and whatever auditory images existed 
 are destroyed with the brain-cells. Yet verbal 
 thought and speech remain unimpaired. The patient 
 
MENTAL IMAGERY AND VOLUNTARY SPEECH 95 
 
 is merely unable to interpret words that he hears. It 
 is evident, then, that oral speech can in some cases 
 be actuated exclusively by kinaesthetic images, the 
 auditory images being dispensable. 
 
 Taking the opposite aspect of the question : Can 
 the auditory images of themselves incite speech? 
 Apparently they can not, though there are several 
 facts that indicate the contrary if they are only 
 superficially examined. It will be well to consider 
 these facts carefully. 
 
 Children that are born deaf do not naturally learn 
 to speak. ^ The usual inference is that the non-de- 
 velopment of speech is due to the absence of auditory 
 imagery. But speech can develop without auditory 
 imagery, and often when hearing is present the sense 
 is little more than a guide during actual enuncia- 
 tion. Hearing is important for the child while he 
 is acquiring speech, even though he be an articulo- 
 moteur; but in spite of this fact he may remember 
 words in terms of feeling and not in terms of hearing. 
 Thus the dumbness of a deaf child cannot be attrib- 
 uted to the lack of auditory images any more than 
 to the lack of kinaesthetic images. His dumbness is 
 due to the fact that he has not had hearing as a guide. 
 
 A child that loses his hearing at the age of five or 
 
 ^ "Puppies, or even dogs, are rendered dumb by the destruction 
 of the internal ear." Waller, "Human Physiology," 3d ed., p. 550 
 (cites Danilewski). 
 
96 THE PSYCHOLOGY OF STAMMERING 
 
 six gradually becomes dumb unless he is drilled in 
 articulation. The dumbness is frequently attributed 
 to the gradual disappearance of the auditory images. 
 The auditory images admittedly fade from conscious- 
 ness, but their disappearance is not necessarily the 
 cause of the muteness. Deafness is a mental cata- 
 clysm for the child; it entails a sweeping change in 
 his psychic life. It would indeed be remarkable if 
 the child should evince a disposition to talk when 
 his own words have ceased to be audible to him. He 
 may attempt to speak, but his world of hearing has 
 been blotted out, and he does not even know whether 
 he is uttering sound or not. He probably beheves 
 that his speech is affected as well as his hearing — if, 
 indeed, he is able to analyze the situation at all. The 
 fact that the child does retain possession of his speech 
 if he is carefully drilled in articulation is conclusive 
 evidence that acoustic images are dispensable for oral 
 speech, for it is generally admitted that privation of 
 hearing at an early age entails obliteration of the 
 auditory imagery. 
 
 There is another argument that is sometimes ad- 
 duced in favor of a purely auditory incitation of oral 
 speech. Occasionally a child gives utterance to 
 several consecutive words in his initial attempt at 
 speech. In such cases the development of speech is 
 usually delayed, and the child makes no use of lan- 
 guage till suddenly moved by some intense emotional 
 
MENTAL IMAGERY AND VOLUNTARY SPEECH 97 
 
 excitement.^ The argument is that, since the child 
 has not previously spoken the words, he can have no 
 kinaesthetic memory of them. From this it is in- 
 ferred that the words are prompted solely by auditory 
 cues. However, in such cases the child usually in- 
 dulges freely in ''baby-chatter" before he utters his 
 initial sentence, and in this way he establishes an 
 association between the feeling and the sound of the 
 syllables he utters. Many of the elementary sounds 
 are thus represented in both kinaesthetic and auditory 
 memory. Cliildren usually learn language in this 
 piecemeal fashion, and they have undoubtedly both 
 kinaesthetic and auditory images of the elements of 
 speech they have mastered. Elements that are not 
 clearly represented in motor memory are mispro- 
 nounced; ultimately they are mastered by process 
 of trial and error. New words are learned by re- 
 combining the different elements, and since these 
 are represented in both kinaesthetic and auditory 
 memory, it is not necessary that a word should be 
 prompted at its first appearance by purely auditory 
 imagery. The articulo-moteur may turn to the 
 dictionary and read off hundreds of words that he 
 has never before pronounced, yet the words are 
 not initiated by auditory cues. He cannot even 
 
 ^ In a case cited by Bastian the child did not speak till he was 
 five years of age. Then, upon breaking a toy, he suddenly ex- 
 claimed, "What a pity ! " 
 
98 THE PSYCHOLOGY OF STAMMERING 
 
 think the words in auditory imagery ; he finds that he 
 must mentally articulate them. This fact con- 
 clusively demonstrates that, when once the elements 
 of speech are mastered, any new combination of them 
 may be represented in kinaesthetic imagery prior to 
 its first enunciation. 
 
 Thus, the arguments in favor of a purely auditory 
 incitation are easily refuted. Those opposed to it 
 are conclusive. 
 
 If it were always possible for one to pronounce 
 words of which he has a clear auditory image ; then 
 the child should blossom into a fluent speaker as soon 
 as the neural speech-mechanism becomes functionally 
 mature.^ As soon as he speaks his first few words, 
 he should be able to pronounce any word that he is 
 able to think in auditory imagery. He should have 
 no difficulty in repeating any word that is spoken 
 to him, for the primary memory would be distinct, 
 even if no secondary memory were to endure. The 
 child should have no difficulty with his G's, X's, Z's, 
 and r/j's. He should be able to trill his R's, and 
 pronounce German gutturals and French nasals the 
 moment he hears them. We know, of course, that 
 
 ^ " For it may fairly be said that the great majority of children 
 can remember the names given to many external objects when they 
 are four or five months old ; their memory in this respect continually 
 increasing through succeeding months, even whilst they still make no 
 very distinct efiforts at articulating words for themselves." Bastian, 
 "The Brain as an Organ of Mind," p. 604. 
 
MENTAL IMAGERY AND VOLUNTARY SPEECH 99 
 
 this is not the case, but that the child usually takes 
 years to master the elements of even his own language. 
 He proceeds by trial and error, and has no thorough 
 command of language till the kinaesthetic images of 
 speech are established. 
 
 Exactly the same argument applies in the case of 
 the adult to the mastering of foreign languages. If 
 speech-initiation could be accompUshed by pure 
 auditory imagery, one should be able, as soon as the 
 auditory memory is established, to utter any sound 
 producible by the speech-organs. The primary 
 memory would be sufficient ; and one should be able 
 to repeat upon the demand the most difficult combina- 
 tions in Chinese, German, Swedish, or any other 
 language. The Enghshman should be able to repeat 
 the uvular R the first time he hears it ; the German 
 should have no difficulty whatever with the English 
 Th. However, this is not the case. Few adults 
 can master even one foreign language and speak it 
 with a pure accent. As Kussmaul says : ^ 
 
 "No living person is able to pronounce the speech-sounds of 
 all the different races of the world. A Lepsius may express 
 them in writing, a Briicke may discover the processes involved 
 in their articulation ; but even such scholars cannot articulate 
 them all. In the speech of every race only certain sounds 
 are developed, while other sounds are entirely neglected. Thus 
 there occurs a national and dialectical mogilalia." 
 
 ^ "Storungen der Sprache," 4th ed., p. 257. 
 
lOO THE PSYCHOLOGY OF STAMMERING 
 
 Yet such difficulty with foreign languages would 
 never arise if auditory imagery were in itself sufficient 
 to incite oral speech. It is evident, then, that there 
 can be no pure auditory incitation of speech, but that 
 kinaesthetic images are also requisite. The audile, 
 then, becomes an audito-moteur when oral expression 
 is concerned. 
 
 The auditory image, nevertheless, plays a con- 
 spicuous role in the evocation of oral language. Any 
 impairment of the auditory brain-centre usually 
 induces a marked disturbance in speech. But the 
 auditory image never assumes exclusive control of 
 oral expression. This is proved by the fact that a 
 person invariably becomes mute if the motor memory- 
 centre is destroyed. 
 
 The auditory image is important in musical ex- 
 pression. There is with some persons an absolute 
 musical memory, — a musical memory that permits 
 them to produce a note of any desired pitch. It is 
 manifest that in such cases the auditory image must 
 be almost exclusively responsible for the note pro- 
 duced, for the note must be remembered as sound, 
 and not as feehng. Again, in singing and whistling, 
 the auditory image determines almost exclusively the 
 nature of the production. But even in singing, the 
 kinaesthetic image plays an important role. The 
 powerful articulations of a concert singer — or of one 
 that sings so that his audience can understand him 
 
MENTAL IMAGERY AND VOLUNTARY SPEECH loi 
 
 — are produced more by images of muscular move- 
 ment than by images of sound. 
 
 Auditory imagery is an important factor — though, 
 again, never the sole factor — in mimetic performances. 
 Frequently the ear-minded person can give faithful 
 imitations of a brogue or a dialect, or he may be able 
 to imitate the timbre of another person's voice. He 
 is able to succeed because he mentally hears the sounds 
 he is about to utter. The articulo-moteur flounders 
 helplessly with the same task. He must experiment 
 with various conformations of the speech-organs ; and 
 if he finds one that gives the desired result, he must 
 remember it by feeling. Naturally enough, he meets 
 with little success as a mimic. But even the audiio- 
 moteur depends upon his kinaesthetic imagery to a 
 great extent. He may not succeed in imitating a voice 
 at the first attempt, but he succeeds after a little 
 practice. The practice, however, does not enhance 
 the vividness of the acoustic imagery; it merely 
 establishes an association between the auditory images 
 and the images of related articulative movements. 
 Mastering the pronunciation of foreign languages is 
 largely a matter of imitation; thus the audito- 
 moteur meets with greater success than the articulo- 
 moteur in this particular field. ^ 
 
 ^ This fact does not refute the former argument concemmg the 
 acquirement of foreign languages. The audile masters a foreign 
 language more readily because his auditory imagery assists him, — 
 
I02 THE PSYCHOLOGY OF STAMMERING 
 
 The import of the foregoing arguments is that the 
 average person, the audito-moteur, employs both 
 his resident and remote verbal images to incite oral 
 speech ; i.e. that he reUes upon both his kinaesthetic 
 and auditory images of words. The kinaesthetic 
 image is a memory-image of the movements of the jaw 
 and lips and of the grosser movements of the tongue ; 
 and it is these movements that are prompted by 
 the motor memory. The more dehcate speech- 
 movements — those producing fine differences in 
 vowel-coloration — undoubtedly occur, in all but the 
 articulo-moteur, in response to the auditory image of 
 the sound desired. The resident, or kinaesthetic, 
 image is in the latter case probably intercalated be- 
 tween the thought of the sound and its utterance; 
 but it is the remote sound-image, the image of the 
 vowel-color, that initiates the process. 
 
 With regard to the cerebral mechanism it is certain 
 that the kinaesthetic memory-centre acts directly 
 upon the executive motor centres. The only ques- 
 tion involved is whether the auditory centre is able 
 to act directly upon the executive motor centres or 
 only through the medium of the kinaesthetic centre. 
 Pathological cases indicate that the latter is the exist- 
 ing condition, but the matter cannot be said to be 
 
 not because the auditory imagery takes entire charge of the enun- 
 dation. Without motor imagery, speech of any kind would be 
 impossible. 
 
MENTAL IMAGERY AND VOLUNTARY SPEECH 103 
 
 definitely settled. In the case of the articulo-moteur 
 the motor mechanism is actuated exclusively from the 
 kinaesthetic memory-centre. A similar condition may 
 prevail with the audito-moteur ; but if such is the 
 case, the kinaesthetic images of the more subtle 
 lingual and laryngeal movements are aroused by the 
 auditory images through association. One fact is 
 established beyond all possibility of doubt, — that 
 with the audito-moteur the integrity of both the kin- 
 agsthetic verbal centre and the auditory verbal centre 
 is essential for oral speech. To express the matter in 
 terms of consciousness : there must be present in the 
 mind a mental image of the feeling of a word, and a 
 mental image of its sound. 
 
 If the feeling-image were a perfect representation 
 of the movements of speech, no sound-image would 
 be necessary. The sound-image supplements the 
 feeling-image where the latter is deficient; in other 
 words, its chief function is to supply the more deHcate 
 movements that produce the vowel. 
 
 A word may be said at this point concerning the 
 speech of the orally taught deaf. The speech-cues 
 of the deaf are both kinaesthetic and articulatory- 
 visual ; the visual images, Hke the auditory images 
 with the normal person, being remote. Visual images 
 cannot incite speech directly, but it is probable that 
 with some deaf persons the primary revival of thought 
 
I04 THE PSYCHOLOGY OF STAMMERING 
 
 takes place in the visual centre, and that the visual 
 articulative images then arouse the images of feeling. 
 The process is analogous to the visile's seeing images of 
 printed words before he mentally hears and feels them. 
 The deaf person employs sight as a substitute for hear- 
 ing, and he interprets the spoken words of another 
 person by visually reading the lips, tongue, and facial 
 muscles. This visual appreciation of speech may be 
 complete before the pupil has gained thorough mas- 
 tery of his own speech-organs ; ^ hence it follows that 
 visual images are not in themselves sufficient for the 
 evocation of spoken language. The words must be 
 felt as well as seen. The delicate movements of the 
 larynx and pharynx, as well as many movements of 
 the tongue, are hidden from view ; and they must be 
 detected by feeling. It is this fact that so greatly 
 retards the pupil in the acquisition of oral speech. 
 Again, the difference between the surd and sonant 
 consonants must be felt rather than seen. One can- 
 not detect by sight the difference between B and P, 
 and D and J", for instance. When the deaf person 
 articulates these letters and such words as gain and 
 cane^ and view and few, he feels the difference between 
 the surd and sonant consonants. The only difference 
 
 ^ "In many oral classes a few of the scholars who are deficient 
 in their speech are able to follow their teacher's lips throughout the 
 course and keep as well to the fore as the others." Farrar, "Arnold 
 on the Education of the Deaf," p. 219. 
 
MENTAL IMAGERY AND VOLUNTARY SPEECH 105 
 
 is in the point at which vocalization begins ; and this 
 difference makes no appeal to sight. 
 
 When the deaf pupil has mastered the art of speech, 
 he frequently interprets the words of other people 
 in terms of feehng: 
 
 "The deaf person, as he reads the face of another, mentally 
 converts what he sees into the organic action by which the 
 sound or sounds are produced ; so much so that he often repeats 
 to himself what he sees the other sa3dng." ^ 
 
 These facts show that the kinaesthetic images are 
 in the deaf at least as conspicuous as those of sight. 
 In speech, the visual image is undoubtedly remote ; 
 its function is that of arousing the kinaesthetic image 
 by association rather than that of acting directly 
 upon the executive motor centres. 
 
 ^ "Arnold on the Education of the Deaf," p. 217. 
 
CHAPTER VI 
 
 IMPAIRMENT OF THE BRAIN-CENTRES: APHASIA 
 
 A PERSON suffering a lesion in one of the memory- 
 centres incurs obliteration or impairment of the cor- 
 responding mental imagery. A lesion in the left 
 occipital lobe destroys the images of sight. Damage 
 to the angular gyrus effaces the visual images of 
 printed or written words. An injury to the first 
 temporal convolution destroys the auditory memory 
 of words; while an injury to the posterior portion 
 of the third frontal convolution destroys the kin- 
 aesthetic verbal memory. 
 
 The lesion must, of course, occur in the memory- 
 hemisphere of the brain; that is, in the left hemi- 
 sphere in right-handed persons, and the right hemi- 
 sphere in left-handed persons. When it occurs in 
 the "other hemisphere, the intellectual life remains 
 practically unaffected. When there is degeneration 
 of the cortex rather than absolute destruction of the. 
 cells, the patient is still able to interpret sensations, 
 though he is unable voluntarily to redintegrate the 
 mental images. The inabiHty to arouse mental 
 images is called amnesia. The inability to interpret 
 
 io6 
 
APHASIA 107 
 
 sensations is called mind-blindness, mind-deafness, 
 etc., according to the nature of the malady. This 
 psychic bhndness or deafness usually involves its cor- 
 responding form of amnesia, but the amnesia does not 
 necessarily involve the inability to interpret sensa- 
 tions. 
 
 Aphasia is a generic term applied to these different 
 forms of cerebral defects. It is applied more partic- 
 ularly to the cerebral disturbances of speech. 
 
 The significance of the loss of a particular type of 
 mental imagery is determined entirely by the promi- 
 nence of the imagery in thought. Deprivation of the 
 visual imagery would be a calamity for an eye-minded 
 person. Loss of the auditory imagery would be dis- 
 astrous to an ear-minded person. But it is safe to 
 say that few people would be inconvenienced by dis- 
 possession of their images of taste and smell, for these 
 images have httle significance for the intellectual 
 life. General intelligence would suffer little from the 
 loss of the musical memory; but such a loss would 
 be calamitous for a composer or a musician. With 
 many persons there is congenital olfactory, gustatory, 
 or musical amnesia ; more rarely there is congenital 
 auditory or visual amnesia. In such cases an injury 
 to the torpid brain-centre would have no eft'ect upon 
 memory. If the injury were profound, it would 
 interfere with perception, but the concepts would 
 remain virtually unaffected. 
 
io8 THE PSYCHOLOGY OF STAMMERING 
 
 Visual Amnesia and Object-blindness 
 
 A lesion in the visual memory- centre (G. V. C, 
 Figure 5) effaces the memory for visual experiences. 
 If the degeneration of the cells is slight, the resultant 
 disturbance may be merely visual amnesia, — in- 
 ability to arouse the visual images. When destruc- 
 tion of the cells is complete, there is object-blindness 
 in addition, and the patient no longer recognizes 
 things that he sees. So long as the primary visual 
 centres are unimpaired, the patient sees as well as 
 ever. But he does not interpret his visual sensations ; 
 the world, as he meets it through sight, is as strange 
 and incomprehensible to him as to a new-born child. 
 He does not recognize a chair as a chair, nor a book 
 as a book. He does not recognize his surroundings ; 
 and if the attack occurs suddenly, he may wander 
 in the streets imagining that he is lost. He may 
 refuse to enter his own home, declaring that the house 
 is unfamiliar. He repudiates his friends, and in 
 general conveys the impression that he is demented. 
 Indeed, if he has no knowledge of the normal workings 
 of his mind, he may himself imagine that he has be- 
 come insane. A visile that becomes subject to such 
 a malady has the most effective part of his mind 
 blotted out. His intelligence is reduced in propor- 
 tion as visual imagery formerly predominated in his 
 thinking. 
 
APHASIA 109 
 
 One of Bernheim's ^ patients was shown a brush, 
 but he failed to recognize or name it. 
 
 "Of what use is it?" he was asked. 
 
 ''It is used for walking," he replied; and when 
 asked for a demonstration he proceeded to make the 
 brush take steps. Later he exclaimed, ''No, it is 
 used for making strokes. No !" ("Non, c'est pour 
 faire des barres. Non !") Then after a few minutes 
 he finally recognized it: "It is used to brush with; 
 it is a brush." 
 
 James ^ gives the following account of one of 
 Charcot's patients that was suffering from visual 
 amnesia and a marked degree of object-bHndness: 
 
 "The patient was Mr. X., a merchant, born in Vienna, 
 highly educated, master of German, Spanish, French, Greek, 
 and Latin. Up to the beginning of the malady which took him 
 to Professor Charcot, he read Homer at sight. He could, start- 
 ing from any verse out of the first book of the Iliad, repeat the 
 following verses without hesitating, by heart. Virgil and 
 Horace were familiar. He also knew enough of modern Greek 
 for business purposes. Up to within a year (from the time 
 Charcot saw him) he enjoyed an exceptional visual memory. 
 He no sooner thought of persons or things, but features, forms, 
 and colors arose with the same clearness, sharpness, and ac- 
 curacy as if the objects stood before him. When he tried to 
 recaU a fact or a figure in his voluminous polyglot correspond- 
 
 ^ Rev. de med., 1885. Quoted by Bastian, "Aphasia and Other 
 Speech Defects," p. 212. 
 
 2 "Principles of Psychology," Vol. II, pp. 58 flf. The original 
 account appears in Pr ogres Medical, 21 juillet, 1883. 
 
no THE PSYCHOLOGY OF STAMMERING 
 
 ence, the letters themselves appeared before him with their 
 entire content, irregularities, erasures, and all. At school he 
 recited from a mentally seen page which he read off Hne by 
 line and letter by letter. In making computations, he ran his 
 mental eye down imaginary columns of figures, and performed 
 in this way the most varied operations of arithmetic. He could 
 never think of a passage in a play without the entire scene, 
 stage, actors, audience, appearing to him. He had been a great 
 traveller. Being a good draughtsman, he used to sketch views 
 which pleased him ; and his memory always brought back the 
 entire landscape exactly. If he thought of a conversation, a 
 saying, an engagement, the place, the people, the entire scene 
 rose before his mind. 
 
 "His auditory memory was always deficient, or at least 
 secondary. He had no taste for music. 
 
 "A year and a half previous to examination, after business 
 anxieties, loss of sleep, appetite, etc., he noticed suddenly one 
 day an extraordinary change in himself. After complete con- 
 fusion, there came a violent contrast between his old and his 
 new state. Everything about him seemed so new and foreign 
 that at first he thought he must be going mad. He was ner- 
 vous and irritable. Although he saw all things distinct, he had 
 entirely lost his memory for forms and colors. On ascertain- 
 ing this, he became reassured as to his sanity. He soon dis- 
 covered that he could carry on his affairs by using his memory 
 in an altogether new way. He can now describe clearly the 
 difference between his two conditions. 
 
 "Every time he returns to A., from which place business 
 often calls him, he seems to himself as if entering a strange 
 city. He views the monuments, houses, and streets with the 
 same surprise as if he saw them for the first time. Gradually, 
 however, his memory returns, and he finds himself at home 
 again. When asked to describe the principal public place of 
 
APHASIA III 
 
 the town, he answered, 'I know that it is there, but it is im- 
 possible to imagine it, and I can tell you nothing about it.' 
 He has often drawn the port of A, To-day he vainly tries to 
 trace its principal outlines. Asked to draw a minaret, he re- 
 flects, says it is a square tower, and draws, rudely, four lines, 
 one for ground, one for top, and two for sides. Asked to draw 
 an arcade, he says, 'I remember that it contains semicircular 
 arches, and that two of them meeting at an angle make a vault, 
 but how it looks I am absolutely unable to imagine.' The 
 profile of a man which he drew by request was as if drawn by 
 a Httle child ; and yet he confessed that he had been helped to 
 draw it by looking at the bystanders. Similarly he drew a 
 shapeless scribble for a tree. 
 
 "He can no more remember his wife's and children's faces 
 than he can remember the port of A. Even after being with 
 them for some time they seem unusual to him. He forgets 
 his own face, and once spoke to his image in a mirror, taking it 
 for a stranger. He complains of his loss of feeling for colors. 
 ' My wife has black hair, this I know ; but I can no more recall 
 its color than I can her person and features.' This visual am- 
 nesia extends to dating objects from his childhood's years — 
 paternal mansion, etc., forgotten. 
 
 "No other disturbances but this loss of visual images. Now 
 when he seeks something in his correspondence, he must rum- 
 mage among the letters like other men, until he meets the pas- 
 sage. He can recall only the first few verses of the Iliad, and 
 must grope to read Homer, Virgil, and Horace. Figures 
 which he adds he must now whisper to himself. He realizes 
 clearly that he must help his memory out with auditor^'- images, 
 which he does with effort. The words and expressions which 
 he recalls seem now to echo in his ear, an altogether novel sen- 
 sation for him. If he wishes to learn by heart anything, a 
 series of phrases for example, he must read them several times 
 
112 THE PSYCHOLOGY OF STAMMERING 
 
 aloud, so as to impress his ear. When later he repeats the thing 
 in question, the sensation of inward hearing which precedes 
 articulation rises up in his mind. This feeling was formerly- 
 unknown to him. He speaks French fluently, but afi&rms that 
 he can no longer think in French; but must get his French 
 words by translating them from Spanish or German, the lan- 
 guages of his childhood. He dreams no more in visual terms, 
 but only in words, usually Spanish words. A certain degree 
 of verbal blindness affects him — he is troubled by the Greek 
 alphabet, etc." 
 
 With an ear-minded person a corresponding cere- 
 bral lesion would have resulted less seriously. The 
 visual images would, of course, have been obhterated ; 
 but their loss would not have been so grave a matter 
 for a person living in a world of sounds. Conversely, 
 the loss of the auditory images would have been a 
 matter of Httle moment for the patient in question, 
 for so long as the verbal imagery were not affected, 
 the intellectual faculties would have been little 
 impaired. 
 
 Defects of the visual memory are often associated 
 with homonymous hemianopsia^ — obliteration of one 
 half of the visual field. This is due to the invasion, 
 by the degenerative process, of the primary visual 
 area in the cuneate lobule and its immediate neigh- 
 borhood. The condition is one of physical blindness. 
 It is anomalous only in the fact that it affects but one- 
 half of the field of vision. If lesions occur in both 
 cuneate lobules, the condition differs in no way from 
 
APHASIA 113 
 
 ordinary physical blindness. When the lesion is lim- 
 ited to the primary visual area, there is no impairment 
 of the visual memory-images. 
 
 Visual Verbal Amnesm, Word-blindness, and 
 
 Agraphia 
 
 A lesion in the angular gyrus (F. V. in Figure 5) 
 annihilates the visual images of printed and written 
 words. A superficial injury may entail merely the 
 inabihty to redintegrate the visual images spon- 
 taneously. In this case there is visual verbal amnesia 
 with agraphia — the inabihty to write. The patient 
 cannot write because he is unable to recall the appear- 
 ance of the word he wishes to pen. When the in- 
 jury is profound, the patient is unable to recognize 
 words that he sees, and the resulting condition is one 
 of word-blindness ^ in addition to the visual verbal 
 amnesia and agraphia. The patient occasionally 
 retains his memory for letters and figures. This is 
 accounted for by the fact that letters and figures are 
 learned first and are consequently more deeply seated. 
 In many instances the explanation is probably the 
 existence of number-forms subserved by the general 
 visual centre rather than the visual verbal centre. 
 
 The word-blind patient understands all that is said 
 to him, and thinks clearly in words so long as the 
 auditory centre is not affected. His difficulty is 
 
 * Word-blindness is sometimes called alexia. 
 
114 THE PSYCHOLOGY OF STAMMERING 
 
 merely in interpreting printed or written words. He 
 sees the words in front of him, but they convey no 
 more meaning than they would if they were upside- 
 down, or were written in a foreign language. 
 
 The agraphia is not always complete. The patient 
 often retains the ability to write his own signature, 
 and perhaps a few short words or letters. These are 
 probably revived in kinassthetic imagery, — the pa- 
 tient writing by feeling. He can copy writing that is 
 put before him, but he does not do so understandingly. 
 He copies print in print, and script in script, writing 
 hke a forger that copies an inverted signature. 
 Occasionally the word-blind person manages to divine 
 the meaning of a written word by tracing it with 
 his finger. In this case, when the angular gyrus is 
 damaged, he interprets the word entirely by feeling. 
 In attempting to write, the patient may produce 
 a jumble of letters, likewise by feeling. This per- 
 version of the faculty of writing is called paragraphia. 
 
 The following is a typical case of word-blindness, 
 visual verbal amnesia, and agraphia, resulting from 
 damage to the angular gyrus : ^ 
 
 "A female, aged 6^), admitted into the Asylum of Villejuif 
 on the 29th of Sept., 1891. Was intelligent, but had lost the 
 power of reading and writing. Being anxious to regain the 
 
 ^ Wyllie, "Disorders of Speech," pp. 349 f. Case reported by 
 S6rieux, Comptes rendus des seances de la Societe de Biologic, Jan- 
 vier, 1892. 
 
APHASIA 115 
 
 power of reading and writing, she practised much with her 
 pen ; but her efforts resulted only in such confused collections 
 of letters as the following — these being, moreover, written 
 badly — in a tremulous hand — ' an um aa monon mono muosir 
 The intelligence was normal, and there were no paralytic symp- 
 toms whatever. Vision was intact, and it is expressly stated 
 that there was no hemianopsia. It was as impossible for the 
 patient to read as to write. She could, however, recognize a 
 few of the individual letters ; and when a word was composed 
 of these she could sometimes spell it out and pronounce it." 
 
 At the autopsy there was found a softening in the 
 angular gyrus and supra-marginal convolution, i.e. 
 in the visual verbal area. 
 
 Word-blindness, strangely enough, does not always 
 entail visual verbal amnesia. If the word-blindness 
 were invariably due to destruction of the angular 
 gyrus, amnesia would be an inevitable concomitant. 
 However, it is sometimes induced by a subcortical 
 lesion severing the visual memory-centre from the 
 primary visual area. The consequence is that the 
 visual sensation is unable to arouse the visual memory- 
 image ; thus no perception can take place. But so 
 long as the cortical cells in the angular gyrus are un- 
 affected, the visual images of words remain unim- 
 paired. The patient writes spontaneously or from 
 dictation with the greatest ease, exciting the graphic- 
 motor centre from the visual verbal centre. But 
 he cannot read the words that he has written, for the 
 excitation in the primary visual area is unable to 
 
ii6 THE PSYCHOLOGY OF STAMMERING 
 
 reach the visual memory-centre. Occasionally the 
 patient can interpret writing by tracing the words 
 with a pen or with his finger. In this case the vis- 
 ual memory-images are aroused by the kinaesthetic 
 impressions. 
 
 The following is a fairly typical case of subcortical 
 word-blindness : ^ 
 
 "The patient was a man aged 68. After a number of attacks 
 of tingling in the right leg and arm, he suddenly perceived that 
 he could not read a single word ; but he still retained the power 
 of writing, and indeed could write with perfect ease. For 
 four years he remained in this condition — totally word- and 
 even letter-blind, but able to write correctly whole pages of 
 manuscript though quite unable to read them after they were 
 written. He had also lost the power of reading musical notes, 
 though he could still sing well. He retained the power of 
 reading figures, and could do mental calculations as well as 
 formerly. He had right homonjrmous hemianopsia. 
 
 " Ten days before his death, he became suddenly affected 
 with very pronounced paraphasia, and with total agraphia; 
 without, however, any paralysis of motion or loss of conscious- 
 ness. There was no trace of word-deafness ; and he retained 
 his intelligence to the end." 
 
 At the autopsy there was found an old lesion that 
 destroyed the primary visual area in the left hemi- 
 sphere (this accounting for the right homonymous 
 hemianopsia) and the commissural fibres uniting the 
 
 ^Wyllie, "Disorders of speech," pp. 339 f. Case reported by 
 D^jerine, Comptes rendus des seances de la Societe de Biologie, mars, 
 1892. 
 
APHASIA 117 
 
 angular gyrus with the primary visual area of the 
 right hemisphere. Thus the patient was blind in 
 one-half of the field of vision ; while impressions from 
 the other half were unable to reach the memory-centre. 
 These facts explain the word-blindness. The in- 
 tegrity of the angular gyrus explains the absence of 
 agraphia. A recent lesion in the angular and supra- 
 marginal convolutions accounted for the disturb- 
 ances that occurred just previous to death. 
 
 A similar case is recorded by Ballet/ but he inter- 
 prets his case somewhat differently. He supposes 
 the patient to have suffered an injury to the angular 
 gyrus, thus incurring obliteration of the visual images 
 of words. In the absence of autopsical examination 
 it is, of course, impossible to determine exactly what 
 happened. There was right homonymous hemianop- 
 sia, so it is probable that the injury was similar to 
 that in the preceding case. The patient was able to 
 write. Ballet supposes that he rehed upon his graphic- 
 motor images. Such a condition would be possible 
 in the motile, especially if he mentally spelled each 
 word and wrote the letters as he mentally pronounced 
 them. It is scarcely conceivable that even the motile 
 should write long words by feeling, without assistance 
 from other forms of verbal imagery. Ballet's ex- 
 planation is not an impossible, though it seems an 
 improbable, one. 
 
 ^ "Le langage int6rieur et I'aphasie," 2d ed,, pp. 104 fif. 
 
ii8 THE PSYCHOLOGY OF STAMMERING 
 
 There seem to be no cases of pure agraphia on record. 
 Agraphia does occur without word-bHndness, but it 
 is usually compHcated by paresis or cutaneous an- 
 aesthesia, and the patient is physically unable to 
 write. The presence of paresis is accounted for by 
 the proximity of the executive motor centres to 
 the kinassthetic memory-centres. In many cases 
 agraphia is accompanied by motor or auditory 
 aphasia, and the inability to write may be due to 
 the obHteration of internal language. 
 
 BaUet ^ records a curious case of kinaesthetic amnesia 
 that came under the observation of Charcot. The 
 patient had lost his ability to play the trombone. 
 He ''had lost the memory of the associated movements 
 of the mouth and hand required for playing the in- 
 strument. All the other motor memories were intact. 
 This musician had forgotten the manipulation of the 
 trombone, just as others forget the manipulation of 
 the pen." 
 
 Aphemia 
 
 We come now to the consideration of cerebral dis- 
 turbances that more directly affect the faculty of oral 
 speech. Aphemia, being the simplest disorder, will 
 be considered first. Aphemia is a disturbance of 
 speech due to lesion of the purely executive motor 
 mechanism. The seat of the lesion may be the 
 cortical motor centre at the foot of the precentral 
 
 1 Loc. cit,, p. 134. 
 
APHASIA 119 
 
 convolution, or the bulbar motor centres, or some 
 point in the efferent tracts. The aphemia usually 
 manifests itself in complete mutism. There is, how- 
 ever, no disturbance of internal language, — either 
 visual, auditory, or kinaesthetic. There is no word- 
 deafness or word-blindness. 
 
 The absence of word-deafness is easily demonstrated 
 by the readiness with which the patient obeys orally 
 imparted instructions. If he is told to take out his 
 watch and wind it, or to take a book and open it at 
 a certain page, he immediately obeys. Absence of 
 word-blindness is shown by the patient's ability to 
 comply with written instructions. Absence of amnesia 
 is not so readily determined, for the patient may 
 respond to external impressions and yet be unable to 
 arouse the mental images spontaneously. Disturb- 
 ances in the motor centre are very frequently accom- 
 panied by hemiplegia, — unilateral paralysis. This 
 is due to the fact that the lesion is seldom limited to 
 the mechanism concerned with speech, but invades 
 other regions as well. When hemiplegia is present, 
 the patient has great difficulty in expressing himself 
 in writing. However, by using the left hand he can 
 express, in a somewhat labored way, thoughts that 
 occur to him spontaneously. This ability shows that 
 he is able to think in verbal imagery. His abiHty 
 to perform arithmetical problems, etc., also shows 
 that internal language is unimpaired. The Proust- 
 
120 THE PSYCHOLOGY OF STAMMERING 
 
 Lichtheim test is often applied to ascertain the 
 condition of the patient's internal language. If the 
 patient's verbal thought is unaffected, he is able to 
 indicate the number of syllables in a word, — the 
 name of an object shown to him, for instance. This 
 he does by making expiratory efforts, by pressing 
 his interlocutor's hand, by tapping on the table, etc. 
 In like manner he indicates the number of letters in 
 a word ; thus demonstrating his abihty to spell the 
 word mentally. 
 
 The ability of the patient to indicate the number of 
 syllables in a word is regarded by some pathologists 
 as evidence of the retention of the kinaesthetic verbal 
 images. The ability to comply with the test is proof 
 of the existence of some form of verbal imagery, but 
 it does not seem to follow that the imagery must 
 necessarily contain the kinaesthetic element. If the 
 audile were able to make the words resound in his 
 mind syllable by syllable, he could certainly comply 
 with the conditions of the test. In the audile it 
 would be scarcely possible to differentiate pure aphe- 
 mia from loss of the kinassthetic memory of words. 
 
 Doctor Samuel Johnson thus describes, in a letter 
 to Mrs. Thrale, a temporary attack of aphemia that 
 befell him in his seventy-fourth year: 
 
 "On Monday, the i6th, I sat for my picture, and walked a 
 considerable way with little inconvenience. In the afternoon 
 and evening, I felt myself light and easy, and began to plan 
 
APHASIA 121 
 
 schemes of life. Thus I went to bed, and in a short time waked 
 and sat up, as has long been my custom, when I felt a confusion 
 and indistinctness in my head, which lasted I suppose about 
 half a minute. I was alarmed and prayed God that, however 
 He might afflict my body, He would spare my understanding. 
 This prayer, that I might try the integrity of my faculties, 
 I made in Latin verse. The lines were not very good, but I 
 knew them not to be very good ; I made them easily and con- 
 cluded myself to be unimpaired in my faculties." ^ 
 
 This attack of aphemia proved to be temporary. 
 
 The following is a case reported by Dejerine.^ 
 The patient, an accountant, had become speechless 
 after an apoplectic attack. 
 
 "He understands readily all questions addressed to him, 
 either orally or by writing. He recognizes all external objects. 
 Cannot utter aloud a single word either spontaneously, by read- 
 ing, repeating, or singing. But he can indicate the number of 
 syllables in the words he wishes to utter, by so many expiratory 
 efforts or pressures with the fingers. By bringing one's ear 
 quite close to his mouth one can distinguish certain words pro- 
 nounced in an excessively low voice — less than a whisper. 
 Some of these words are not pronounced correctly, the articu- 
 lation of the labials being especially interfered with — the h 
 being pronounced like an m. And the same mistakes occur 
 when he attempts to read or repeat a phrase as when attempt- 
 ing to utter them spontaneously. . . . The right hemiplegia 
 being slight, the patient can make use of a pen, and writes 
 either spontaneously, from dictation, or in copjdng. This he 
 does fairly legibly and with no mistakes." 
 
 ^ Quoted by Bastian, " Aphasia and Other Speech Defects," 
 p. 66. ^ Quoted by Bastian, loc. cii., p. 70. 
 
122 THE PSYCHOLOGY OF STAMMERING 
 
 At the necropsy there were found three small foci 
 of softening : one beneath the lower extremity of the 
 fissure of Rolando, one beneath the posterior ex- 
 tremity of the third frontal convolution, and one be- 
 neath the foot of the precentral convolution. Either 
 of these last two lesions might have caused the aphe- 
 mia. The one beneath the kinaesthetic memory-centre 
 would have isolated the image-centres from the motor 
 region. The one at the foot of the precentral con- 
 volution would have interfered with the l^emission of 
 the motor current. 
 
 Articulatory-kin^sthetic Aphasia 
 
 Articulatory-kincEsthetic aphasia, or motor aphasia^ 
 is due to the total or partial obliteration of the kin- 
 aesthetic images of articulatory movements. It is 
 caused by lesion of the posterior part of the third 
 frontal convolution of the left hemisphere {K. V. in 
 Figure 5). Motor aphasia is usually associated with 
 right hemiplegia, this being due to the extension 
 of the lesion into the true motor area of the brain. 
 Strictly delimited lesions do not induce hemiplegia. 
 The onset of the malady is usually abrupt ; and if the 
 lesion is extensive, the patient is speechless from the 
 beginning. If the patient is an audile, there is no 
 verbal amnesia so long as the auditory area is un- 
 affected. The patient has clear acoustic images of 
 words, but is unable to translate them into kinaes- 
 
APHASIA 123 
 
 thetic images in order that he may express them. He 
 is in the position of a man that can recall orchestral 
 music, but has no means of externalizing his acoustic 
 thoughts. If the patient is an articulo-moteur, in- 
 ternal language is annihilated. Since the average 
 person is an audito-moteur, there is usually con- 
 siderable amnesia. Patients with motor aphasia 
 interpret spoken language with varying degrees of 
 facility. At the beginning of the attack there is 
 frequently considerable word-deafness owing to the 
 inabihty of the acoustic impressions to arouse their 
 kinaesthetic associates. 
 
 The following is a case of aphasia due to the partial 
 destruction of the kinaesthetic memory-centre. The 
 case is reported by Collins.^ 
 
 "Mrs. X — , a widow, sixty-three years old, the mother of 
 eight children, has had a vigorous, active life, free from ill 
 health, save that twelve years ago she suffered severely from 
 attacks of renal calculi. During the past year or two she has 
 complained of indigestion and more recently of a dull, aching 
 sensation in the back of the head and neck, with occasional 
 attacks of very severe pain in the left temple. For a few weeks 
 previous to the beginning of her present symptoms she suffered 
 from insomnia, from irritability, nervousness, and forgetful- 
 ness. Her son, a physician, gives the following account of 
 the onset of her aphasic symptoms. One week before consult- 
 ing me she discovered, while making a call, that her speech had 
 become, without warning, very much embarrassed. She could 
 not finish the sentence she had started to speak. She forgot 
 
 1 "The Faculty of Speech," pp. 422 ff. 
 
124 THE PSYCHOLOGY OF STAMMERING 
 
 what she wanted to say. She chafed under this impotence and 
 got very much excited. She returned home in a street car, and 
 was much astonished to discover on looking at the signs with 
 which the cars are Hned that she was quite unable to compre- 
 hend their signification. She could see the letters and words, 
 she knew that they were letters and words, but they conveyed 
 no meaning to her. \Vhen she got home she tried to tell her 
 family about her disability, but was able to say only a few words, 
 and these were entirely disconnected. After trying to speak 
 for a time she became excited and began to cry. On the follow- 
 ing day when she awakened, she could say only 'Yes' and 
 'No,' but as the day wore on her vocabulary became somewhat 
 larger. It was particularly remarked that when she was ex- 
 cited or very emotional sometimes words would flow out of her 
 mouth in an astonishing manner. From that time until I 
 saw her there had not been very much change in her capacity 
 for speech production. 
 
 "The following is a stenographic report of the examination 
 to determine the disorder of voluntary speech. In response 
 to the question to tell me all that she could concerning the onset 
 and course of her symptoms, she said : 
 
 "'Well, mem-mem — three weeks, m-m-em — feel-m-em- 
 em — sometimes [prolonged pause, seems to be thinking] 
 couldn't thought — no thought — forget — but — eh — last 
 Friday [another prolonged pause] am — no — noticed they — 
 I couldn't — eh — I [prolonged pause] I couldn't tell, am, I 
 don't, I can't, can't express [explosively] I can't tell — I can- 
 not [points to her head and looks weary]. It seems, I can't, 
 last Monday, con-con-nects — sentence, two or three words — 
 gone. Was — gone, blank, didn't know. Can't think, was 
 gone, forget — forget everything. Couldn't, couldn't, can't.' 
 
 "To test her capacity to repeat, I asked her to say after me : 
 *I stood on the bridge at midnight.' Her reply was: 
 
APHASIA 125 
 
 (( c- 
 
 I stood — the — night/ said with great effort, and with 
 apparent endeavor to repeat each word as quickly as they fell 
 from my lips. 
 
 "'Still sits the schoolhouse by the road ? ' 
 
 " 'Forget — yes — the — the — s's's' forget — road.' " 
 
 The patient's internal language was probably as 
 defective as her speech. She indicated her inability 
 to repeat inwardly the Lord's Prayer, and she was 
 unable to write either spontaneously or from dicta- 
 tion. She understood fairly well what was said to 
 her ; hence the auditory centre could not have been 
 destroyed. Destruction of the kinaesthetic centre was 
 incomplete ; otherwise the patient would have been 
 mute. 
 
 Destruction of Broca's convolution does not neces- 
 sarily entail obliteration of internal language. If the 
 patient happens to be an audile, there may be no amne- 
 sia verbalis whatever. In fact, the case does not then 
 differ in its symptoms from one of pure aphemia. In 
 the following case of articulatory-kinassthetic aphasia 
 (recorded by Guido Banti) the patient was mani- 
 festly an audile, and he thought in auditory verbal 
 images after the kinaesthetic images had been ex- 
 punged : ^ 
 
 1 Bastian, "Aphasia and Other Speech Defects," p. 89. Case re- 
 ported by Guido Banti in "Afasia e sue Forme, Lo Sperimental," 
 1886, LVII, obs. II, p. 270, and quoted by Prevost in the Revue 
 medicale de la Suisse Romande, June 30, 1895. 
 
126 THE PSYCHOLOGY OF STAMMERING 
 
 "A right-handed man, aged 36, who was able to read and 
 write correctly, had a sudden apoplectic attack in 1877. Re- 
 covering consciousness in a few minutes he was found to be 
 suffering from right hemiplegia and loss of speech. The paraly- 
 sis of the limbs disappeared almost completely during the 
 following night, though the inabihty to speak persisted. 
 
 "The next day he was admitted into hospital, and on most 
 careful examination his condition was found by Guido Banti 
 to be as follows: 
 
 "'The motihty of the limbs on the right side had returned 
 to their normal condition. There was no trace of paralysis 
 of the face or of the tongue. The patient made ineffectual 
 attempts to speak ; he could not articulate a single word, not 
 even isolated syllables. He was much affected by this mutism, 
 and sought to make himself understood by gestures. I asked 
 him if he knew how to write, and after he had made a gesture in 
 the affirmative I gave him what was necessary and told him to 
 write his name, which he did immediately. I put various other 
 questions to him, to which he replied similarly by writing. I 
 told him to give me a description of his illness, and he wrote 
 without hesitation the details above reported. I showed him 
 various objects, pieces of money, etc., telling him to write their 
 names, and he did so without making any mistakes. Then 
 instead of giving him these directions by word of mouth, I 
 wrote them for him in order to thoroughly convince myself 
 that he was able to understand writing. He replied to these 
 questions with perfect correctness. He always wrote very 
 rapidly and did not seem to hesitate to choose his words. He 
 made no mistakes in syntax or orthography. He could under- 
 stand equally well ordinary writing and print, and when one 
 spoke to him he grasped at once the meaning of the questions, 
 and never wished to have them repeated. I next wrote some 
 most simple words such as "pain," "vin," etc., and urged him 
 
APHASIA 127 
 
 ineffectually to read them aloud. I then pronounced myself 
 some of the words, directing him to repeat them. He appeared 
 to watch with great attention the movements of my lips whilst 
 I spoke ; he made some ineffectual efforts to obey, but he 
 never succeeded in pronouncing a single word.' 
 
 "This patient died in February, 1882, from an aneurism 
 of the aorta ; and a patch of yellow softening was found situated 
 in the posterior third of the third left frontal convolution, and 
 extending for some millimetres only into the white substance." 
 
 It will be seen that the kinaesthetic memory-centre 
 was completely destroyed. 
 
 If the patient had happened to be an articulo- 
 moteur, there would undoubtedly have been com- 
 plete verbal amnesia. Taking another point of view 
 — if the lesion had occurred with this patient in 
 the first temporal convolution, the auditory images 
 of words would have been blotted out, and the 
 patient would probably have been incapable of 
 verbal thought. 
 
 The two following cases show clearly the different 
 consequences that an affection of Broca's centre may 
 entail. Both cases exhibit jargon-aphasia ; but in 
 one, internal language remained intact, while in the 
 other it was distorted. 
 
 The first is one of Dr. Osborn's cases, quoted by 
 Bastian in ''The Brain as an Organ of Mind." ^ 
 
 ^ "The Brain as an Organ of Mind," pp. 667 ff. Dr. Osborn's 
 account appears in the Dublin Journal of Medical and Chemical 
 Science, Vol. IV, p. 157. 
 
128 THE PSYCHOLOGY OF STAMMERING 
 
 "A scholar of Trinity College, Dublin, twenty-six years of 
 age, of very considerable literary attainments, and well versed 
 in French, Italian, and German, whilst sitting at breakfast, 
 after having bathed in a neighboring lake, suddenly had an 
 apoplectic fit. He was reported to have become 'sensible in 
 about a fortnight,' but, although restored to the use of his in- 
 tellect, he had the mortification of finding himself deprived of 
 speech. He spoke, but what he said was quite unintelligible, 
 although he labored under no paralytic affliction and uttered 
 a variety of syllables with the greatest apparent ease. When 
 he came to Dublin his extraordinary jargon led to his being 
 treated as a foreigner in the hotel where he stopped ; and when 
 he went to the college to see a friend he was unable to express 
 his wish to the gate porter, and succeeded only by pointing to 
 the apartments which his friend had occupied. 
 
 "Dr. Osborn, after frequent careful investigations, ascer- 
 tained the following particulars concerning his patient : — 
 
 "i. He perfectly comprehended every word said to him. 
 
 "2. He perfectly comprehended printed language. He 
 continued to read a newspaper every day ; and when examined 
 proved that he had a clear recollection of all that he read. 
 Having procured a copy of Andral's 'Pathology' in French 
 he read it with great diligence, having lately intended to em- 
 brace the medical profession. 
 
 "3. He expressed his ideas in writing with considerable 
 fluency; and when he failed it appeared to arise merely from 
 confusion, and not from inability, the words being orthographi- 
 cally correct, but sometimes not in their proper places. 
 
 "4. His general mental power seemed unimpaired. He 
 wrote correctly answers to historical questions ; he translated 
 Latin sentences accurately ; he added and subtracted numbers 
 of different denominations with uncommon readiness; he also 
 played well at the game of draughts. 
 
APHASIA 129 
 
 "5. His power of repeating words after another person 
 was almost confined to certain monosyllables ; and in repeating 
 the letters of the alphabet he could never pronounce k, q, u, 
 V, w, X, and z, although he often uttered these sounds in attempt- 
 ing to pronounce the other letters. The letter i, also, he was 
 very seldom able to pronounce. 
 
 "6. In order to ascertain and place on record the peculiar 
 imperfection of language which he exhibited, Dr. Osborn selected 
 and laid before him the following sentence from the bye-laws 
 of the College of Physicians, viz. '// shall he in the power of the 
 College to examine or not examine any Licentiate previous to his 
 admission to a Fellowship, as they shall think fit J 
 
 "Having set him to read, he read as follows: — 'An the he 
 what in the temother of the trothotodoo to majorum or that emi- 
 drate eni enikrastrai mestreit to ketra totomhreidei to ra fromtreido 
 as that kekritestJ The same passage was presented to him a 
 few days afterwards and he then read it as follows: — 'Be 
 mather he in the kondreit of the cofnpestret to samtreis amtreit 
 emtreido and iemtreido mestreiterso to his eftreido turn bried re- 
 deriso of deid daf drit des trestJ 
 
 "He generally knew that he spoke incorrectly, although he 
 was quite unable to remedy the defect." 
 
 It is easy to show that the defective speech was 
 due to some perversion of function in the kinaesthetic 
 verbal centre {K. V. in Figure 5). The patient had 
 full possession of internal language; hence one of 
 the verbal memory-centres must have been intact. 
 It could not have been the kinaesthetic centre, for 
 if this had been intact, the patient would have had 
 no difficulty in oral expression. It is evident that 
 the kinaesthetic centre was damaged. If the auditory 
 
I30 THE PSYCHOLOGY OF STAMMERING 
 
 centre (instead of the kinaesthetic centre) had been 
 damaged, the patient would have had less difficulty 
 in repeating spoken language, for the cerebral dis- 
 turbance was manifestly of an incipient nature. With 
 incipient softening or a functional disturbance in the 
 kinaesthetic centre, and with the patient an audile, 
 one would expect the very symptoms that prevailed, 
 — retention of internal language and manifestation 
 of jargon-aphasia. 
 
 In the second case there was distortion of the verbal 
 imagery. The case is one of transitory aphasia that 
 befell the writer less than a year ago, — giving him 
 a valuable insight into the subjective aspect of aphasia. 
 As in the case just described, the disturbance was in- 
 duced by exposure to cold. 
 
 The writer was in the Rocky Mountains, crossing 
 a pass at an elevation of 12,000 feet. A violent 
 storm prevailed. There was heavy rain, and a freez- 
 ing wind against which it was difficult to stand. The 
 writer attempted to communicate with another mem- 
 ber of the party, and found to his astonishment that 
 his language was completely unintelligible. It was, 
 in fact, the meaningless jargon of aphasia. For a 
 moment the disturbance was thought to be due to 
 a benumbed condition of the articulative organs ; but 
 this belief was quickly dispelled. As soon as the 
 nature of the disturbance was recognized, the writer 
 undertook an introspective analysis of the mental 
 
APHASIA 
 
 131 
 
 condition. The results would naturally be more 
 valuable if it had been possible to anticipate the in- 
 cident and plan the analysis beforehand. As it 
 was, the introspection was improvised imder con- 
 ditions of physical and mental distress attendant 
 upon exposure to cold ; and many valuable points 
 that might otherwise have been examined were over- 
 looked. Nevertheless, the results are interesting and 
 instructive. 
 
 In the first place, there was no knowledge of the 
 aphasic condition till the attempt was made to speak. 
 The thought-processes had not been in any way em- 
 barrassed. The sound of the wind and rain was 
 clearly interpreted, and all visual and tactual impres- 
 sions carried their proper import. Verbal communi- 
 cations from other members of the party were clearly 
 understood. In short, the perceptual and conceptual 
 processes seemed normal ; and it is doubtful whether 
 the aphasic condition would have been noticed if no 
 occasion for speech had arisen. (Ihis seems all the 
 more likely since the aphasia disappeared soon after 
 a more protected part of the mountains was reached. 
 This occurred ten or fifteen minutes after the disturb- 
 ance was first noticed ; and as the thought-processes 
 had not been thoroughly introspected, the writer re- 
 turned — with more zeal than wisdom — to an exposed 
 position in the pass in order to restore the conditions 
 for the analysis. The aphasia thereupon returned.) 
 
132 THE PSYCHOLOGY OF STAMMERING 
 
 In regard to speech, it was noticed that articu- 
 lation was somewhat labored and spasmodic ; but there 
 was no similitude between the sounds uttered and 
 those appropriate for the expression of the thought. 
 Initial consonants, vowels, and final consonants were 
 jumbled promiscuously, and more than half the words 
 were distorted beyond recognition. Here and there 
 a word was intact, and occasionally only one con- 
 sonant in a word would be mutilated. The writer 
 could tell immediately whether or not the sounds 
 uttered were appropriate. If a word happened to be 
 pronounced correctly, or was only partly distorted, 
 the fact was immediately recognized. 
 
 Introspection showed that verbal thought was an 
 exact counterpart of speech. There occurred the 
 same jumble and confusion in the verbal imagery, and 
 it was impossible to express a thought clearly in in- 
 ternal language. When an attempt was made to 
 translate a visual thought into mental words, nothing 
 resulted but mental gibberish. 
 
 As stated, there was, however, no discernible im- 
 pairment of intelligence. Even abstract thought 
 seemed unaffected, and thoughts were clearly form- 
 ulated in the mind, although they could not be ex- 
 pressed in mental speech. These thoughts were 
 conducted chiefly in visual and motor imagery. 
 
 The visual images were normal and could be redin- 
 tegrated at will. Visual images of different scenes, 
 
APHASIA 133 
 
 faces, etc., were recalled with normal facility. 
 Thoughts expressed themselves spontaneously in 
 images of sight. In many cases these visual thoughts 
 were saved from obHvion only by a sudden chopping- 
 off of the stream of consciousness. One thought that 
 may be noted can be expressed verbally as follows: 
 ^'I wonder if they have sheltered in the shaft-house." 
 The thought referred to the other members of the party. 
 It consisted in nothing more than a visual image of 
 these persons taking shelter in the place in question. 
 An attempt was made to express the thought in verbal 
 images, and then in spoken words. In both cases the 
 product was gibberish. The visual images alone 
 carried the meaning, and the verbal images that they 
 would ordinarily have aroused by association refused 
 to be invoked. One point is worth noting : When by 
 dint of persistent effort a few coherent words were at 
 last mentally or orally produced (this occurred when 
 the attack was passing off) , these words could usually 
 be mentally or orally repeated. Any considerable 
 pause annulled the possibility. 
 
 Unfortunately it was not noticed whether visual 
 images of words could be aroused. If any had ap- 
 peared spontaneously, they would undoubtedly have 
 been detected.^ No attempt was made to read or 
 
 ^ The writer can ordinarily arouse faint visual images of printed 
 or written words. These images do not usually accompany his 
 verbal thought. 
 
134 THE PSYCHOLOGY OF STAMMERING 
 
 write. This matter was entirely overiooked. No 
 auditory images were present apart from the auditory 
 images in the mental jargon. This mental jargon — 
 like the writer's ordinary verbal imagery — was 
 auditory-motor with practically only the vowel-ele- 
 ments in auditory terms. Motor images of hand- 
 and arm-movements were fairly clear. They were, 
 perhaps, somewhat less definite than under normal 
 conditions. They appeared to be a little ''labored," 
 but were still well defined. This impression of 
 labored kinaesthetic images may have been produced 
 by the numbed condition of the body. 
 
 The abnormal manifestations of speech gradually 
 disappeared when the writer returned to a more 
 sheltered part of the mountains where he was pro- 
 tected from the severity of the wind. All marked 
 disturbances disappeared within half an hour; but 
 throughout the day there was a decided tendency 
 toward syllable-stumbling. Words were frequently 
 misplaced in the sentence. A severe headache was 
 experienced for several hours after the incident. 
 
 The aphasia was undoubtedly induced by cold. 
 The tenuity of the atmosphere could not alone have 
 been responsible for the disturbance, for at other 
 times greater altitudes — with more favorable weather 
 conditions — produced no such effect. 
 
 The cerebral disturbance was undoubtedly some 
 functional derangement in the kinaesthetic verbal 
 
APHASIA 135 
 
 centre. This diagnosis was borne out by introspection. 
 When an attempt was made to express a thought in 
 internal language, there resulted a sort of spasm of 
 kinaesthetic images. The motor images of articu- 
 lative movements had passed out of control : they 
 "exploded" into consciousness instead of rising in 
 the mind in an orderly manner ; and they were, 
 moreover, promiscuous and inappropriate. Auditory 
 images of vowels followed the kinaesthetic images of 
 consonants, but since the consonants were inap- 
 propriate, the vowels cannot be said to have been 
 either right or wrong. 
 
 An analysis of the symptoms shows that the defect 
 could not have been in the auditory centre. An 
 affection of the auditory centre would not be likely to 
 induce jargon-aphasia with the writer, for the leading 
 centre is in his case the kinaesthetic centre. Whatever 
 auditory images exist are aroused by association with 
 motor images of initial articulative movements. In 
 this jargon-aphasia, however, the words began incor- 
 rectly, the articulative movements themselves being 
 beyond control. 
 
 A comparison of this case with the one preceding 
 shows again that disturbances in speech and thought 
 vary according to the prominence of the different t}'pes 
 of imagery in the thought-processes. Dr. Osborn's 
 patient was not able to speak, because he could not 
 recall the necessary kinaesthetic images. He was able 
 
136 THE PSYCHOLOGY OF STAMMERING 
 
 to think in words because he could recall words in 
 auditory terms. The writer was unable to speak be- 
 cause he, too, could not recall the kinaesthetic images ; 
 but he was unable to think in words because — unlike 
 the former subject — he could not recall these words 
 in auditory terms. 
 
 Auditory Aphasia 
 
 We come now to the consideration of speech-dis- 
 turbances induced by lesion of the auditory verbal 
 centre, — in the posterior part of the first temporal 
 convolution (A. V. in Figure 5). Total destruction 
 of this centre entails obHteration of the auditory 
 images of words. As a consequence there is, of 
 course, complete word-deafness, and the patient 
 understands nothing that is said to him. If the 
 patient is an audile, there is Hkewise complete 
 verbal amnesia, and the patient cannot think in 
 words. If the person affected should be a marked 
 articulo-moteur, no verbal amnesia need result, for 
 the words are still thought in kinassthetic images. 
 The patient is then able to read, write, and speak 
 with normal facihty. Word-deafness, however, in- 
 variably exists. 
 
 It must be understood that the word-deaf patient 
 hears quite clearly what is said to him, for even when 
 there is extensive damage to the memory-hemi- 
 sphere of the brain, the impressions are still received 
 
APHASIA 137 
 
 by the uninjured hemisphere. The words, however, 
 convey no meaning. The patient hears merely a 
 confusion of oral sounds that might as well be words 
 in a foreign language. If the injury to the auditory 
 centre is shght, the word-deafness may be incom- 
 plete, and the patient understands here and there a 
 word that is spoken to him, or understands a simple 
 sentence if it is several times repeated. If a severe 
 lesion is restricted to the auditory verbal centre, the 
 patient — though completely word-deaf — readily in- 
 terprets ordinary physical sounds. He understands 
 the significance of a knock at the door, the ringing 
 of a bell, the ticking of a clock, etc., and he recognizes 
 and appreciates music. 
 
 As already stated, the severity of the disturbance 
 in verbal thought and speech is dependent upon the 
 degree of prominence of the auditory verbal imagery 
 under normal conditions. The symptoms in dififerent 
 cases are by no means uniform. There may be 
 complete verbal amnesia or no amnesia whatever. 
 The disturbance in speech is, of course, commensurate 
 with the disturbance in internal language, — for the 
 patient cannot speak words that he is unable to think. 
 There may be some amount of paraphasia due to 
 "uncontrolled" activity of the kinaesthetic memory- 
 centre. The speech is paraphasic because there is 
 no auditory imagery to guide it. This symptom is 
 more likely to prevail in ear-minded persons. 
 
138 THE PSYCHOLOGY OF STAMMERING 
 
 The following is a case of auditory aphasia due to 
 destruction of the auditory verbal memory-centre : ^ 
 
 "A woman, aged 43 years, who had never suffered from 
 deafness or affection of vision, was attacked on June 22, 1880, 
 with right hemiplegia and aphasia. She remained in the hos- 
 pital until August 4, when she was discharged. At this time 
 the patient could speak, but she spoke unintelligibly, and was 
 sometimes believed to be intoxicated. She not only could not 
 make herself understood, but she could not understand what 
 was said to her. 
 
 "She was received into the hospital again on September 10, 
 with slight paresis of the left arm. The right hemiplegia had 
 entirely disappeared. The patient was looked upon as insane. 
 She was absolutely deaf, so that she could not be communicated 
 with." 
 
 At the autopsy a lesion was found in the auditory 
 verbal memory-centre. The lesion encroached upon 
 the second and third temporal convolutions. There 
 was a somewhat similar lesion in the right hemisphere, 
 but this would not have affected the verbal memory. — ■ 
 The patient was able to give utterance to oral sounds 
 because the kinaesthetic memory persisted. The 
 speech was defective because there was no auditory 
 imagery to guide it, and because the patient was de- 
 pendent upon auditory cues. 
 
 In the following case (reported by Pick ^) it will be 
 
 iBastian, "Aphasia and Other Speech Defects," pp. 161 f. 
 Quoted by Bastian from Farrier, "Lectures on Cerebral Localization." 
 
 ^ Archiv fur Psychologie, 1892, p. 909. Quoted by Bastian, 
 " Aphasia and Other Speech Defects," p. 166. 
 
APHASIA 139 
 
 seen that the patient was an articulo-moteur, and that 
 there was no verbal amnesia or defective speech despite 
 the fact that the auditory memory-centre was totally 
 destroyed : 
 
 "A day laborer, aged 24, was completely word-deaf, and 
 behaved like a deaf person, taking no notice of ordinary sounds 
 near him. It was found that he only noticed loud calls, clap- 
 ping, or ringing of bells, and this not always readily. Yet if 
 one shouted to him unexpectedly, he said, angrily, 'Don't 
 shout at me so ' ; and he often said spontaneously, * I hear quite 
 weU, but I don't understand ; I can hear a fly flying past me.' 
 His power of recognizing airs previously known to him seemed 
 to be also lost. 
 
 "His speech was perfectly correct. He spoke fluently, and 
 only occasionally hesitated about the right word. He named 
 objects shown to him correctly. He could not repeat words 
 or phrases. Writing was executed slowly but quite correctly, 
 though he could not write from dictation. With regard to his 
 power of copying, nothing could be stated, as he could not be 
 persuaded to make the attempt. He read aloud easily and 
 quite correctly, and he understood both print and writing 
 perfectly. Writing afforded the only means of communicat- 
 ii;g with him apart from gestures. The patient's condition 
 in the above-mentioned respects remained essentially unchanged 
 during the whole period of his stay in the hospital, from January 
 17 to May 12, 1891. 
 
 "At the necropsy the upper parts of both temporal lobes 
 were found to be shrunken, soft, and of a yellow color. On 
 the left side the posterior half of the upper temporal convolu- 
 tion and the supra-marginal gyrus were the parts that were 
 softened. The island of Reil was intact. On the right side 
 there was softening of the upper temporal convolution and a 
 
I40 THE PSYCHOLOGY OF STAMMERING 
 
 great part of the second temporal, as well as of the island of Reil, 
 together with some small foci in the lower part of the ascend- 
 ing frontal [precentral], and in the third frontal convolution." 
 
 Since the auditory verbal memory-centre was de- 
 stroyed, the only reasonable explanation for the ab- 
 sence of amnesia and speech-disturbances is that the 
 man was an articulo-moteur, and that verbal images 
 subsisted normally in kinaesthetic terms. Like other 
 people that have no auditory imagery, he would, 
 before his illness, recognize sounds when he heard 
 them, but he would be unable to revive them as 
 acoustic images in his mind. This absence of acoustic 
 images accounts for the absence of speech-disturbances 
 and amnesia when the auditory centre was destroyed. 
 The patient suffered no more in speech than would 
 a congenitally deaf person that had mastered oral 
 language.^ 
 
 1 The suggestion has been made that this patient spoke, like an 
 orally taught deaf person, from visual as well as from kinaesthetic 
 cues. This is highly improbable. One that has made no study of 
 visual speech has practically no optical images of the different posi- 
 tions and movements of his articulative organs. Let the reader 
 verify this statement by endeavoring to obtain visual images of the 
 different movements that his speech-organs would execute in pro- 
 ducing the sentences he is at present reading. If he has not made 
 a study of visual speech, he will find these images to be rudimentary 
 to the last degree. He probably cannot tell, without an actual trial, 
 whether in the enunciation of the letter F, the upper teeth touch 
 the lower lip, or the lower teeth touch the upper lip. If visual 
 images of speech exist, they will be confined almost exclusively to 
 images of labial action. Physiologists have spent years of pains- 
 
APHASIA 141 
 
 Instances are not at all rare of patients giving 
 utterance to familiar phrases after they have suffered 
 destruction of the auditory memory-centre. The 
 phenomenon shows what an important part the kin- 
 aesthetic memory plays in the evocation of speech, — 
 and, with some people, in the thought-processes. 
 The following case, somewhat similar to the one 
 preceding, came under the observation of Hitzig. 
 The report is taken from Bastian.^ 
 
 "An old lady, supposed to be suffering from softening of the 
 brain, was at a loss in speaking for a certain number of words, 
 whilst she was also very slightly paraphasia. Nevertheless, 
 she was able to express herself so well that at a first examina- 
 tion no speech trouble might be noticed. 
 
 "She was completely unable to understand what was said 
 to her. But after a time, when her condition had somewhat 
 
 taking work to ascertain the action of the less observable organs of 
 speech. All this work would have been superfluous if they could 
 have visualized these actions from the beginning. It can be safely 
 stated that the average person has visual images of the action of his 
 speech-organs no more than he has visual images of the movements 
 of his diaphragm. 
 
 If this laborer had visual images of speech-movements, he should 
 have been a competent lip-reader and should have had no difl&culty 
 in interpreting spoken language. 
 
 Visual images of printed or written words need not be considered. 
 They cannot incite speech : they arouse the speech-images only by 
 association. The only images that they could arouse in this instance 
 would be kinaesthetic. 
 
 It seems clear, then, that in this case the incitatives of speech 
 were kinaesthetic images of articulative movements. 
 
 1 Loc. cit., pp. 329 f. 
 
142 THE PSYCHOLOGY OF STAMMERING 
 
 improved, Hitzig says, ' She took notice when one pronounced 
 certain words, though I beUeve she did not understand them, 
 but that she recognized rather by analogy the sound of what 
 was uttered, looking to her previous experiences.' 
 
 "She had, however, very completely preserved her com- 
 prehension of music ; she appreciated airs that were simg or 
 whistled ; and she herself sang and reproduced airs, though not 
 always very correctly. 
 
 "After a time she showed symptoms which pointed to the 
 existence of a new focus of softening — this time in the right 
 hemisphere. 
 
 "At the necropsy an area of softening was found in the left 
 hemisphere, occupying principally the temporal lobe and more 
 especially the posterior two-thirds of the first temporal convolu- 
 tion. This old softening was probably the cause of her word- 
 deafness. In the right hemisphere there was a symmetrical 
 focus of recent date in the temporal lobe." ^ 
 
 It will be seen from the nature of the lesions that 
 the auditory images of words must have been destroyed; 
 yet the patient gave utterance to complete sentences. 
 As a rule, intelligent speech is inhibited by a lesion 
 in the auditory verbal centre, and it is only in rarer 
 instances that the patient gives expression to several 
 words in rational sequence. 
 
 ^ A somewhat similar case is reported by Wernicke in "Der 
 Aphasische Symptomencomplex." This is quoted by Ballet, "Le 
 langage interieur et I'aphasie," 2d ed., p. 86; and by Wyllie, "Dis- 
 orders of Speech," p. 285. 
 
APHASIA 143 
 
 The Relation between Motor and Auditory 
 
 Aphasia 
 
 It might be profitable to consider at this juncture 
 the points of similarity and difference between motor 
 and auditory aphasia. These points may best be 
 studied under three headings: the reception and 
 interpretation of speech; the retention of the 
 verbal images in memory; and the expression of 
 oral speech. 
 
 The Reception and Interpretation of Speech. — In 
 auditory aphasia, the word-deafness is always com- 
 mensurate to the amount of damage in the auditory 
 verbal centre. When destruction of the centre is 
 complete, the word-deafness is complete. If only part 
 of the centre is destroyed, or if the whole centre is 
 enfeebled rather than annihilated, the patient may 
 interpret an occasional word that he hears, or may 
 grasp the meaning of a whole phrase if it is several 
 times repeated to him. If the patient happened to 
 be an orally taught deaf person, it is evident that a 
 lesion in the first temporal convolution would have 
 no injurious effect upon speech ; the integrity of this 
 centre would not be necessary, since the patient 
 would interpret speech entirely by vision. 
 
 It seems at first sight that there should be no word- 
 deafness with pure motor aphasia, since the auditory 
 word-images are not affected. No word-deafness 
 
144 THE PSYCHOLOGY OF STAMMERING 
 
 occurs with the audile, but the articulo-moteur may 
 have difficulty in interpreting spoken language. 
 However, he gathers the meaning when the words are 
 slowly and clearly uttered, or he understands them 
 when they are repeated. When the auditory centre 
 is destroyed, the word-deafness is, on the other hand, 
 complete. 
 
 The Retention of the Verbal Images in Memory. — 
 The amount of amnesia that exists with a lesion in 
 the auditory or kinaesthetic memory-centre varies 
 with the prominence of the different types of imagery 
 in verbal thought. The audile has his internal lan- 
 guage annihilated if an injury occurs to the auditory 
 verbal centre. On the other hand, the articulo- 
 moteur or the orally taught deaf person finds that his 
 internal speech is practically unaffected by such a 
 lesion. When an injury occurs to Broca's centre, 
 it is the articulo-moteur that suffers : his verbal 
 memory is expunged. The pure audile — Guide 
 Banti's patient is an example ^ — thinks in words as 
 freely as ever. 
 
 The audito-moteur suffers when either centre is 
 affected, the degree of the amnesia varying, of course, 
 with the individual. Wyllie believes that verbal 
 amnesia is common with motor aphasia. He says : 
 
 "There is reason to believe that in every case of severe motor 
 aphasia that is due to destruction of the motor images, Amnesia 
 
 ^ See p. 126. 
 
APHASIA 145 
 
 Verbalis is extremely well marked, — even more so, perhaps, 
 than it is in severe cases of auditory aphasia." ^ 
 
 Collins expresses a similar opinion : 
 
 "Patients with cortical motor aphasia often show great 
 amnesia and lack of comprehensive grasp of facts that have 
 been commmiicated to them since their illness." ^ 
 
 The Expression of Oral Speech. — The impairment 
 of oral speech is proportional to the amount of kinaes- 
 thetic amnesia that exists. If destruction of Broca's 
 centre is complete, the patient becomes mute even 
 though he may think clearly in auditory images of 
 words. Frequently a few of the brain-cells seem to 
 escape damage, and the patient gives expression to 
 such recurring utterances as "tan- tan," "list com- 
 plete," etc. When the impairment of the kinaesthetic 
 centre is functional rather than organic, or when the 
 lesion is slight, the patient may exhibit a considerable 
 degree of jargon-aphasia or paraphasia. He gives 
 utterance to meaningless syllables when he attempts 
 to speak, or uses words that are entirely inappropriate. 
 
 When the auditory area is affected, the patient's 
 ability to speak is proportional to his ability to sum- 
 mon the kinaesthetic images of words independent of 
 his images of hearing.^ With Pick's patient we see 
 
 ^ "Disorders of Speech," p. 312. 
 
 2 "The Faculty of Speech," p. 173. 
 
 3 On this subject Starr writes as follows : "If, in the patient with 
 word-deafness, there is no accompanying word-blindness, he may 
 
146 THE PSYCHOLOGY OF STAMMERING 
 
 that there was full ability to recall these images of 
 feehng.^ With the audile, no such ability would be 
 likely to exist, and the patient would be unable to 
 give utterance to intelHgible speech. At best there 
 would be paraphasia and jargon-aphasia, due to the 
 uncontrolled activity of the kinaesthetic centre. With 
 a partial disablement of the auditory centre, para- 
 phasia is Ukely to result. The degree of jargon- 
 aphasia is determined largely by the severity of the 
 lesion. 
 
 When the auditory area is enfeebled rather than 
 destroyed, the patient can usually repeat words that 
 he hears spoken. This matter will be discussed sub- 
 sequently at greater length. 
 
 The cases of aphasia cited in the preceding pages 
 are typical of disturbances that occur with degenera- 
 tion in strictly delimited cortical areas. It frequently 
 happens, however, that a lesion covers only part of a 
 
 be able to read aloud as well as to himself — that is, his motor speech 
 memory may be aroused by way of his visual memories without the 
 intervention of the auditory memories. And if he has no apraxia 
 [loss of concepts] it is also possible for any of the concept memories 
 to awaken the motor speech memory; hence the thought of an 
 object or seeing it may lead to the enunciation of its name without 
 thought of how the name sounds. For this reason patients who 
 are word-deaf and cannot understand what is said to them may be 
 able to talk fairly well." ("Organic and Functional Nervous Dis- 
 eases," 2d ed., pp. 456-457.) 
 1 pp. 139 f- 
 
APHASIA 147 
 
 particular centre. The function is then only partially 
 inhibited. In other cases the lesion falls along the 
 borders of two adjoining centres. It then happens 
 that there is impairment of both faculties, but sub- 
 version of neither. In other cases, again, the lesion 
 may be more extensive and may affect two or three 
 centres simultaneously. Several subjective disturb- 
 ances, such as auditory and visual amnesia or word- 
 deafness and mind-blindness, then coexist, and the 
 patient's intelligence is reduced to a minimum. 
 
 ASSOCIATIONAL ApHASIA 
 
 Lesions producing aphasia are not necessarily 
 situated in the cerebral cortex; they are frequently 
 found in the association-tracts uniting the different 
 centres of the brain. As already stated (p. 115), a 
 lesion severing the fibres between the primary visual 
 centre and the visual verbal memory-centre will 
 produce word-blindness without agraphia. The pa- 
 tient cannot read because the visual impressions 
 do not arouse their associated memory-images. 
 These memory-images can, however, be aroused spon- 
 taneously, and they are at the service of the patient 
 when he desires to write. He writes spontaneously or 
 from dictation, but he cannot read what he has him- 
 self written. 
 
 It has already been explained that in such cases the 
 patient sometimes manages to read in a rather crippkd 
 
148 THE PSYCHOLOGY OF STAMMERING 
 
 way by tracing the letters with a pen or with his 
 finger. In these cases the kinaesthetic sensations 
 arouse the visual images of the words, and the process 
 is exactly the reverse of that which takes place during 
 the act of writing. 
 
 All ideas that are associated by contiguity can thus 
 arouse one another mutually. The association, as 
 already stated, is stronger in the direction represent- 
 ing the order of the occurrence of the impressions ; 
 but it exists in the other direction none the less. 
 Pathological phenomena show that the association- 
 fibres conducting stimuli from one centre to another 
 are not the same as the fibres conducting stimuli in 
 the reverse direction ; in other words, the association- 
 tracts are double. Since contiguous association can 
 take place between any two ideas, one naturally con- 
 cludes that there must be double association-tracts 
 between any two brain-centres that may be designated. 
 
 A peculiar condition, known as optic aphasia, is 
 produced by interruption of the fibres that convey 
 stimuli from the visual memory-centre to the verbal 
 memory-centres. There is no object-blindness- The 
 patient recognizes objects with facility: but the 
 stimulus cannot pass to the verbal memory-centres; 
 hence the patient is unable to recall the names of 
 objects that he sees. When the object is made to 
 appeal to another sense — touch, hearing, or taste, 
 for instance — the patient is able to name it immedi- 
 
APHASIA 149 
 
 ately. He might, of course, do the same thing if he 
 suffered from pure object-bKndness ; but since there 
 is no object-bHndness present and no amnesia (for 
 the name can be aroused through other channels), it 
 follows that the difficulty is merely one of association. 
 
 If the lesion happened to occur in the set of fibres 
 that convey stimuh from the auditory word-centre 
 to the visual memory-centre, there would result — in 
 the eye-minded person, at least — a marked degree of 
 word-deafness. The subject would hear the words, 
 but the words would not arouse their visual associates ; 
 hence in many instances they would not be under- 
 stood. The condition would differ little from word- 
 deafness produced by degeneration of the auditory 
 centre. There would, however, be less disturbance 
 in physical speech. 
 
 Theoretically there are as many different assoda- 
 tional disturbances as there are association-tracts in 
 the cerebrum. Many pathological cases have been 
 recorded that bear out the different classifications. 
 But most of these cases show complications due to the 
 encroachment of the lesions upon other parts of the 
 cerebrum, and in many instances, too, no autopsical 
 examination has been recorded; hence it would not 
 be profitable to consider these cases at length. The 
 characteristic symptoms of any particular case should 
 be obvious from what has already been said concern- 
 ing association and the nature of aphasia. 
 
I50 THE PSYCHOLOGY OF STAMMERING 
 
 A few remarks, however, may be made concerning 
 the defects of speech that result from a breach in the 
 fibres miiting the auditory and kinaesthetic word- 
 centres. These fibres cross the Sylvian fissure, 
 passing beneath the island of Reil. Undoubtedly 
 they are double, but owing to their propinquity they 
 are not Hkely to be separately damaged. The nature 
 of the disturbances attendant upon damage to these 
 fibres is determined by the relative prominence of 
 the two centres in the verbal processes. A pure 
 articulo-moteur would suffer no disturbance in oral 
 expression. Speech would be initiated from Broca's 
 centre, and the isolation of this centre from the audi- 
 tory region would have Kttle significance. The audito- 
 moteur or audile (the audile, of course, becoming an 
 audito-moteur where oral expression is concerned) 
 exhibits jargon-aphasia or paraphasia from a similar 
 lesion. There is usually no word-deafness, or no more 
 word-deafness than would result from destruction of the 
 kinaesthetic centre. Internal language is not impaired 
 in the pure audile or pure articulo-moteur, though 
 naturally it becomes affected in the audito-moteur if he 
 is not able, after the occurrence of the lesion, to restrict 
 his verbal thought to one particular type of imagery. 
 
 The following is a case of paraphasia due to inter- 
 ruption of the audito-kinaesthetic association-tract : ^ 
 
 * Collins, "The Faculty of Speech," p. 418, The case was orig- 
 inally reported by Lichtheim. 
 
APHASIA 151 
 
 "A man, forty-six years old, with incomplete right-side 
 hemiplegia. No history could be obtained. Examination 
 showed that the patient understood spoken, written, and 
 printed speech. The most remarkable feature of the case was 
 paraphasia, which was so great that spoken speech was quite 
 unintelligible. He was aware of the mistakes in his production 
 and tried to assist himself by pantomime. Writing was very 
 imperfect ; he disarranged the order of the letters and the words, 
 and it was difficult to get him to make efforts of writing. The 
 same defect was manifested in attempting to repeat as when he 
 endeavored to speak voluntarily. He retained the ability to 
 copy. The autopsy showed extensive lesions, the chief one, 
 according to the writer, being of the island and of the floor of 
 the Sylvian fissure." 
 
 The symptoms vary greatly in different cases ; 
 hence the foregoing case cannot be said to be typical. 
 The paragraphia indicates impairment of internal 
 language or the existence of complications affecting 
 the visual area or fibres connected with it. 
 
 When damage occurs to the projection-fibres lead- 
 ing from the motor areas of the brain, the resultant 
 disturbance is aphemia. The symptoms are identical 
 with those produced by a lesion in the motor cortex. 
 Internal language is, of course, unaffected. 
 
 Amusia 
 
 Amusia is a generic term for disturbances in the 
 musical faculty. These defects are quite analogous 
 to the various forms of aphasia. We find tone-deaf- 
 
152 THE PSYCHOLOGY OF STAMMERING 
 
 ness, note-blindness, musical amnesia, etc., analogous 
 to the different defects in speech. Defects in the 
 musical and speech faculties may coexist or exist 
 independently of each other. 
 
 The independent occurrence of disturbances in the 
 musical faculty points to the existence of a separate 
 centre presiding over the musical memory. The 
 facts of development carry similar import. 
 
 "Musical recognition in childhood often precedes verbal 
 recognition.^ Musical expression usually precedes verbal ex- 
 pression, both when there is clearly inherited musical tendency, 
 and in ordinary imitative reactions." ^ 
 
 The disparity in the development of the musical 
 and speech faculties is often remarkable. Ballet 
 states ^ that Stumpf 's child could sing the scale 
 correctly at the age of fourteen months. He cites 
 further the case of the son of the composer, Dvorak, 
 who at one year could sing with his nurse the march 
 from "Fatinitza." At eighteen months he could sing 
 his father's songs, the latter accompanying him on the 
 piano. The faculties of speech and song frequently 
 interfere with each other's development. The writer 
 has a nephew that developed a remarkable propen- 
 sity for singing at the age of two. When less than 
 
 ^ Verbal recognition of course requires the establishment of asso- 
 ciations. — C. S. B. 
 
 2 Baldwin, "Mental Development of the Child and Race," p. 
 440. 
 
 ' "Le langage int^rieur et I'aphasie," 2d ed., p. 24. 
 
APHASIA 153 
 
 two and a half, he could sing accurately the melody 
 of " La donna e mobile," from '' Rigoletto." But when 
 the musical faculty began to develop, all attempts at 
 speech seemed to disappear. At the age of three the 
 child began to employ words again, but he had then 
 no more command of language than he had at eighteen 
 months. 
 
 This independent development of the faculties 
 would scarcely take place if the musical and auditory 
 verbal memories were subserved by the same centre. 
 Physiologists are pretty well agreed that the auditory 
 musical memory resides in the anterior portion of the 
 first temporal convolution. The posterior two-thirds, 
 it will be remembered, presides over the auditory 
 memory for spoken words. When the whole superior 
 temporal convolution is damaged, there result both 
 amusia and aphasia. When the lesion is limited to 
 the anterior portion, there occurs amusia without 
 aphasia. When the damage is restricted to the 
 posterior portion, aphasia alone results. 
 
 The visual memory for musical notations seems to 
 reside in a different portion of the cortex from that 
 presiding over the memory for ordinary letters. The 
 visual images pertaining to music are probably stored 
 in the general visual centre. 
 
 Tone-deafness is usually accompanied by musical 
 amnesia. Lack of musical imagery is normal with 
 a large proportion of the race. A certain amount of 
 
154 THE PSYCHOLOGY OF STAMMERING 
 
 natural tone-deafness is likewise common, a great 
 many people being unable to appreciate intricate 
 classical music. Pathological tone-deafness results, 
 of course, from actual degeneration in the cerebrum, 
 and it is often accompanied by word-deafness. Collins ^ 
 cites a case, originally reported by Serieux, in which 
 there was total word-deafness. In addition, ''The 
 most famihar times when played on any instrument 
 were not recognized. 'Au Claire de la Lune,' was 
 said to be a 'dead march.' Cafe chantant music 
 was designated church music, etc." 
 
 "Lichtheim has reported a very instructive example of 
 amusia. His patient was a teacher and journalist, who be- 
 came completely word-deaf after a second attack of apoplexy. 
 Communication with the patient could be made only in writing. 
 He heard when one sang or whistled, but he did not recognize 
 the melodies. Concert singing by his children was most annoy- 
 ing because it was 'so noisy.' The most familiar melodies, 
 such as 'Rufst du mein Vaterland,' were not recognized." ^ 
 
 Dr. Brazier cites a number of interesting cases of 
 amusia.^ In one case a tenor in the comic opera was 
 suddenly stricken with musical amnesia during the 
 performance. He was unable to understand what 
 was being sung, and was himself unable to produce 
 
 1 Collins, "The Faculty of Speech," p. 260. 
 
 2 Collins, loc. cit., p. 260. 
 
 '"Du trouble des facult6s musicales dans I'aphasie," Revue 
 philosophique, October, 1892, pp. 337-368. Reviewed in Zeitschrift 
 fur Psychologie und Physiologic der Sinnesorgane, Vol. 5, pp. 345 ff- 
 
APHASIA 155 
 
 a note. He could speak with fair fluency, but had 
 forgotten the words and music of his songs entirely. 
 The disturbance disappeared after several months. 
 In another case a well-known pianist was playing a 
 piece from memory, with orchestral accompaniment. 
 Suddenly he forgot the piece, and the music of the 
 orchestra appeared to him as a mere confusion of 
 sounds. There was no trace of aphasia. It is evident 
 that the disturbances in musical expression were due 
 in these two cases to the loss of auditory musical 
 memory. 
 
 The musical memory is not necessarily auditory, 
 though of course it usually takes this form. For 
 instrumental music, the memory may be visual or 
 motor. The visile may learn a piece of music by 
 visualizing the notes, and he would naturally depend 
 upon his images of sight. The motile can learn to 
 play pieces from memory, even if he has no acoustic 
 imagery. Any disturbance in his kinaesthetic imagery 
 of hand-movements would then interfere with musical 
 expression. It will be remembered that one of Char- 
 cot's patients had lost the memory for associated 
 movements of the hands and mouth necessary for 
 playing the trombone. In such cases musical ex- 
 pression would be impaired even if the auditory 
 memory were unaffected. 
 
 Conditions of note-bhndness (called also musical 
 alexia) and musical agraphia occasionally occur. 
 
156 THE PSYCHOLOGY OF STAMMERING 
 
 When the damage causing the disturbance is Kmited 
 to the visual area, the patient may still play well by 
 ear. Kussmaul ^ refers to a patient of Finkeln- 
 burg's that could play well by ear, though he had 
 lost the power of interpreting written music. A 
 patient of Lasegue's ^ that suffered from aphasia and 
 agraphia was able to write the notes to any melody 
 he heard. A patient of Proust's ^ could compose and 
 write music, but was totally unable to play from notes. 
 This disturbance was probably produced by a lesion 
 in the fibres uniting the primary and secondary visual 
 centres. Such a lesion would account for the absence 
 of musical agraphia, since the visual memory-centre 
 would be unimpaired. 
 
 The Ability of an Aphasic Patient to Sing 
 
 Returning to the subject of vocal music, we find 
 that the patient is usually unable to sing when he is 
 imable to speak. However, he may still be able to 
 hum or whistle airs with the greatest accuracy, or 
 he may sing by attaching musical sounds to a few 
 meaningless syllables that he is still able to articulate. 
 But it occasionally happens that an aphasic patient 
 can sing words that he cannot express in ordinary 
 speech. In such cases the defect of speech is un- 
 doubtedly due to auditory amnesia, the kinassthetic 
 word-images being unimpaired. A case of this nature 
 
 ^ See Kussmaul, "Storungen der Sprache," 4th ed., p. 193. 
 
APHASIA 157 
 
 is recorded by a writer in the Psychological Review} 
 
 He says : 
 
 "A patient now under his observation [the author writes 
 in the third person] with total loss of the power of speaking, 
 the understanding of speech being preserved, is being success- 
 fully taught to sing in a high pitch words which he cannot be 
 taught to say." 
 
 Bastian quotes a case from Knoblauch, in which 
 the patient could sing words that she could not 
 pronounce : ^ 
 
 ''The patient was a girl, aged six years, who could neither 
 read nor write. After recovering from an attack of scarlet 
 fever followed by nephritis, she was seized with general convul- 
 sions on December 21, 1886. 
 
 "'On December 26 consciousness slowly returned, but there 
 remained a condition of right hemiplegia with aphasia. The 
 child could not speak at all at first. Later on she said 
 " Mamma," and apparently repeated a few words. She could 
 sing the song "Weisst Du wie viel Sternlein stehen," etc., but 
 she could not recite the text of the song, or speak voluntarily 
 single words of the same.' 
 
 "Soon after she improved in general health, but on February 
 8, 1887, she was admitted into the CHnical Hospital at Heidel- 
 berg on account of the hemiplegia and the speech defects. In 
 regard to the latter the following details are given : ' Men- 
 tally, as far as one can judge, she is very well developed. As 
 she is aphasic she has to make herself understood by gestures ; 
 spontaneously she only utters "Mamma." She is able to repeat 
 a few words, but very imperfectly. If one commences the song 
 
 1 Vol. I, No. I, January, 1894. 
 
 'Bastian, "Aphasia and Other Speech Defects," p. 288. 
 
158 THE PSYCHOLOGY OF STAMMERING 
 
 "Weisst Du wie viel Sternlein stehen," she sings it with the 
 right melody in an automatic way, being unable either to con- 
 tinue or to begin afresh when she once stops. All the words of 
 the text which she is unable to pronounce spontaneously are, 
 while she sings them, articulated perfectly. The comprehen- 
 sion of spoken language is quite normal. The patient has not 
 yet learnt to read or wTite.' 
 
 "After this date she improved remarkably under treatment, 
 so that by February 21 'she was able to repeat most words cor- 
 rectly, with considerable trouble it is true. She could count 
 up to three if some one started her with ''one." In the begin- 
 ning of March she was able to sing the song "Weisst Du wie 
 viel Sternlein stehen" quite alone, and certainly with a much 
 purer intonation than at the beginning of the treatment. On 
 March 8, she succeeded for the first time in reciting the text 
 of the song without singing the melody. In the beginning of 
 April the patient had acquired a considerable vocabulary, and 
 she even attempted to form small sentences. In the middle of 
 the same month she could utter almost all words, but could not 
 yet form connected sentences, though she managed to make 
 herself perfectly understood.'" 
 
 Bastian gives an account of another case, which 
 came under his own observation. The patient was 
 a woman, aged forty. When admitted to the hospital 
 (October i, 1897) she was completely word-blind and 
 almost completely word-deaf. Her condition later 
 was as follows : ^ 
 
 "November 25. Examination by the House Physician 
 (Dr. J. S. Collier). No word-deafness now. She corrects me 
 directly when I make a mistake in the multiplication table. 
 
 1 Bastian, loc. cit., pp. 291 f. 
 
APHASIA 159 
 
 The only words she uses voluntarily are 'no,' which she uses 
 correctly, and 'Bull,' the name of the patient next to her. If 
 the alphabet be repeated slowly to her she joins in and will 
 continue to repeat it alone correctly. Sometimes, however, she 
 makes a mistake, shakes her head and says 'no,' and cannot 
 continue until she is started afresh. When started by counting 
 aloud, she can count up to twenty alone, with some defects of 
 articulation, such as 'en' for ten, 'fixteen' for sixteen, 'tenty' 
 for twenty. She cannot say the easier part of the multiplica- 
 tion table. She cannot repeat a single word after me. She 
 was made to say 'eighteen, nineteen, twenty,' about a dozen 
 times by leading up with ' sixteen, seventeen, ' repeated by me 
 aloud, and then when I asked her to say ' twenty ' she did so at 
 once, but could not repeat the performance. 
 
 "She can sing a tune to order. She commences humming 
 and then joins in mth the words, many of them perfectly articu- 
 lated, some of them badly articulated, and in the place of others 
 mere lalling. The following is a specimen of her singing of the 
 hjonn 'Hark, hark, my soul,' her mistakes being printed in 
 itaUcs. 
 ' Hark, hark, my soul, angeHc songs are swelling 
 
 O'er earth's green eas (seas) and ocean's nave mint ore (wave- 
 beat shore). 
 
 How sweet the truth those blessed strains are selling (telling) 
 
 Of that new life where sin shall be no more.' 
 
 "She sang three verses of this hymn. She also sang to order 
 verses of the following hymns : — ' Onward, Christian soldiers' ; 
 'Jesu, meek and gentle'; 'Awake, my soul'; 'At even ere 
 the sun was set' ; and others, as well as some popular ballads, 
 such as 'Belle Mahone' ; 'Cherry ripe,' etc. 
 
 "She can start singing these herself. She can, moreover, 
 repeat the above mentioned verses without singing if she is 
 started by my beginning them aloud, but she caimot say them 
 
i6o THE PSYCHOLOGY OF STAMMERING 
 
 without being first put upon the track. Her articulation of 
 quite difficult words in the singing is often very good, but in 
 repeating poetry her articulation is not so good as when she 
 sings. 
 
 "She cannot repeat a single word dictated to her. 
 
 "She is still absolutely word-bHnd. She names letters but 
 
 quite wrongly. When shown a letter upside down, she at once 
 
 placed it right side up. When shown her own name she evidently 
 
 did not recognize it ; she spelt it out, but did not get a single 
 
 letter right, thus — 
 
 Sarah Brown 
 
 iptea eavrno 
 
 "December ii. She is still completely word-blind; she 
 cannot pick out a single letter, or recognize her own name spelt 
 with capitals. She has said a few more words spontaneously, 
 such as 'oranges' and 'fish.' She still cannot name any object 
 that is shown to her. She can now repeat words a little, such 
 as 'father,' 'paper,' 'nice,' — has done so about a dozen times 
 in all. She understands complicated orders at once, and obeys 
 correctly." 
 
 It will be seen from the foregoing report that the 
 patient was practically devoid of spontaneous speech, 
 though she was able to sing with considerable facility. 
 The fact that she could count, and recite words in 
 a quasi-automatic manner, is not surprising. This 
 phenomenon is often seen when the defect occurs in 
 the auditory centre. The words are produced me- 
 chanically, and they do not represent verbal thought 
 in the true sense of the word. When the answer to 
 a question requires the enunciation of a simple num- 
 ber, the patient frequently remains mute, — even 
 
APHASIA i6i 
 
 though he may be able to count in a mechanical way. 
 Singing may be easier for these patients because it 
 is a mechanical rather than a thought process. 
 
 Transitory Aphasia 
 
 Aphasic attacks are often transitory, lasting for 
 minutes, hours, days, or even months. These attacks 
 are due to functional disabilities rather than to lesion 
 of the cerebral tissue. 
 
 Daly records a case ^ in which there were recurring 
 attacks of transitory aphasia with right hemiplegia. 
 In one day there were as many as ten attacks, varying 
 in length from ten to sixty minutes. The patient 
 would suddenly say, ''I am all right again," and the 
 attack would be at an end. The power in the hemi- 
 plegic limbs returned almost as soon as the faculty of 
 speech. Bastian suggests that the attacks were due 
 to spasms of the cerebral blood-vessels induced by 
 uraemic poisons in the blood. 
 
 Ballet ^ states that he has frequently induced 
 temporary attacks of aphasia in himself by excessive 
 tobacco-smoking. He ascribes the affection to a 
 disturbance of the kinaesthetic memory. He has 
 found his auditory and visual verbal images to be clear 
 at such times, though the words themselves could not 
 be pronounced. 
 
 1 Quoted by Bastian, loc. cit., pp. ii6 f. 
 
 2"Le langage int6rieur et I'aphasie," 2d ed., pp. 118 f. 
 
i62 THE PSYCHOLOGY OF STAMMERING 
 
 Trousseau records the case ^ of Professor Rostan, 
 who experienced an attack of temporary aphasia. 
 He was confined to his bed for several days by an 
 injured leg, and fatigued his brain by excessive reading. 
 When the attack came on, he noticed that he did not 
 clearly understand what he was reading. When he 
 tried to call for assistance, he found that he could not 
 utter a word. He was also unable to express his 
 thoughts in writing. He was bled, and he then 
 found that he could say a few words. The recovery 
 was gradual, and at the end of twelve hours was com- 
 plete. 
 
 In another case ^ a minister found himself aphasia 
 one morning, after being exposed on the previous 
 evening to the night air and receiving "a check to 
 the cutaneous perspiration." The patient understood 
 everything that was said to him, but was himself 
 unable to utter a word. When he attempted to ex- 
 press himself in writing, he wrote the meaningless 
 phrase, "Didoes doe the doe." He was bled of fifty 
 ounces of blood; thereupon he recovered rapidly. 
 
 Kussmaul ^ records the case of a thirteen-year-old 
 girl that remained aphasic for thirteen months, — 
 the effect of being run over by a vehicle. She re- 
 
 ^ Cited by Bastian, loc. cit., p. 115. 
 
 2 Bateman, "On Aphasia," 2d ed., p. 83; quoted by Bastian, 
 loc. cit., pp. 115 f. 
 
 ' "Stbrungen der Sprache," 4th ed., p. 213. 
 
APHASIA 163 
 
 ceived no severe injuries, but remained speechless 
 from the shock. After various specifics had proved 
 ineffectual she was treated with potassium bromide. 
 One day, after taking the medicine, she threw herself 
 in her mother's arms, and whispered, "Mother, I 
 am going to speak again." In a few weeks she had 
 completely recovered her lost faculty. 
 
 Intense emotional excitement sometimes induces 
 temporary attacks of aphasia. Anger or fear may 
 leave a person speechless for days. Todd ^ refers 
 to the case of a man of irritable temperament who 
 became so excited during a conversation that he 
 completely lost his power of speech. He remained 
 aphasic for a week. 
 
 The power to "speak with tongues," which ac- 
 companies reHgious ecstasy and is frequently re- 
 garded as a supernatural manifestation, is doubtless 
 nothing more than a passing attack of jargon-aphasia. 
 
 Lowered Excitability of Brain-centres 
 
 Aphasia frequently results from functional weak- 
 ness of the verbal centres. In such cases it usually 
 takes the form of amnesia without word-deafness or 
 word-blindness. (Defects of this nature are likewise 
 common when there is incipient softening in the cere- 
 brum.) The patient forgets first the names of things 
 
 ^ "Clinical Lectures on Diseases of the Brain," p. 278; cited by 
 Bastian, loc. cit., p. 124. 
 
i64 THE PSYCHOLOGY OF STAMMERING 
 
 that he can think of in visual terms ; hence the names 
 of concrete objects are the first to go. Abstract 
 noims, verbs, prepositions, etc., usually have the 
 verbal image as the nucleus of the concept; hence 
 the verbal image is in this case less readily displaced. 
 Amnesic defects are often induced by causes that 
 affect the cerebrum only indirectly; they operate by 
 lowering the general vitaHty of the nervous system. 
 Such causes are old age, extreme fatigue, debihtating 
 diseases, etc. 
 
 Trousseau has recorded in his Lectures a case of 
 amnesia due to lowered vitality of the verbal centres: ^ 
 
 "'You remember the experiment that I often repeated at 
 Marcou's bedside. I placed his nightcap on the bed and asked 
 him what it was. But after looking at it with close attention 
 he could not tell what it was called. He would exclaim, "And 
 yet I know weU enough what it is, but I cannot recoUect." 
 When I told him that it was a nightcap, he would reply, " Oh, 
 yes! it is a nightcap." '"^ 
 
 The same thing occurred when he was tested with 
 other objects. He could seldom name them, but he 
 recognized the names when they were mentioned. 
 In two minutes the name was again completely for- 
 gotten. In this case the sole disability was amnesia. 
 The patient recognized words and could repeat them ; 
 but owing to the enfeeblement of the verbal centres 
 he could not arouse the word-images spontaneously. 
 
 * Ballet, "Le langage interieur et I'aphasie," 2d ed., pp. 80 f. 
 
APHASIA 165 
 
 Wyllie quotes a similar case in his ^'Disorders of 
 Speech." ^ 
 
 The patient, a man aged twenty-seven, sustained 
 a fracture at the base of the skull. There was some 
 disturbance in vision, and a shght '^motor paresis" in 
 the right side of the body. At first there was word- 
 deafness, but this soon passed 9ff. 
 
 "The peculiar feature of the case has yet to be stated. It 
 was a most remarkable shortness of memory for objects seen, 
 and for words seen or heard. The sound-image of a word, or 
 the visual image of either a word or an object, could easily be 
 revived from without, and its revival called up the correspond- 
 ing idea or meaning in the normal way ; but, as to visual images, 
 immediately when the object or word was withdrawn from the 
 patient's sight its image vanished, and he totally forgot what 
 object or word he had been looking at ; and so also as to sound- 
 images, he heard the word spoken to him and understood it, 
 but immediately forgot it, and could not repeat it, even if only 
 a very short interval was allowed to elapse before he was asked 
 to do so. 
 
 "Shown a knife, he knew what it was, and, if he could not 
 recall the noun 'knife,' he said it was something for cutting with ; 
 but if the knife was then placed among other objects, and covered 
 from his sight for a moment, he could not, when the collection 
 of objects was again uncovered, tell which of them had been 
 shown to him. 
 
 "It was the same with visual images of letters and words. 
 Shown, for example, the letter G cut out in wood, he easily 
 recognized it ; but if it was then covered from his sight, and 
 
 1 "Disorders of Speech," pp. 384 f. The case is recorded by 
 Professor Grashey, Archiv fiir Psych., xvi, 1885, p. 645. 
 
i66 THE PSYCHOLOGY OF STAMMERING 
 
 placed among other wooden letters, he immediately forgot 
 what letter he had seen, and failed to pick it out from among 
 the others, unless he kept repeating to himself 'G, G, G,' and 
 thus artifically retained it in his memory. 
 
 "And it was, again, the same with the sound-images of 
 words. He could repeat or echo any word spoken to him, but 
 the memory of it immediately vanished, if he did not retain it 
 artifically by repeating it over and over again." 
 
 In this case, again, it is evident that there was no 
 destruction of the brain-cells. The defects were due 
 merely to lowered excitability of the centres. 
 
 The Ability of an Aphasic Patient to Repeat 
 
 When the disturbances producing aphasia are 
 situated in the auditory verbal centre, and when the 
 cortical cells are not destroyed, the patient can usually 
 repeat words that are spoken in his hearing. He may 
 possess this ability even when he can utter scarcely a 
 word spontaneously. The ability of the patient to 
 repeat words can be regarded as an indication of the 
 integrity of the kinaesthetic memory-centre. 
 
 Instances are numerous in which aphasic patients 
 have been able to pronounce words spoken in their 
 hearing. It will be remembered that the little girl that 
 could sing when she could not speak spontaneously, 
 *'was able to repeat most words correctly" (p. 158). 
 Even when she sang " Weiss t Du wie viel Sternlein 
 stehen," she had at first to be accompanied, or some 
 one had to commence the melody for her. 
 
APHASIA 167 
 
 The explanation for a patient's ability to repeat 
 when unable to speak spontaneously is most probably 
 that the cortical cells are too much enfeebled to permit 
 the spontaneous evocation of the auditory image, but 
 not sufficiently weakened to resist the auditory impres- 
 sion. The sensory stimulus overcomes the inertia of 
 the cells, and while the primary memory endures, the 
 patient is able to repeat the words that he could not 
 otherwise pronounce. The phenomenon sometimes 
 takes the form of echolalia, and the patient reechoes 
 almost any word that he hears, frequently attaching 
 no meaning to it. 
 
 This condition was observed in one of Collins' 
 patients that suffered from word-deafness, word- 
 blindness, and object-blindness. Part of the report 
 of the case is subjoined : ^ 
 
 "Examination of this patient eight months later reveals 
 practically the same condition as above stated, save that the 
 word-deafness is, if changed at all, more complete. The hemi- 
 anopsia is very difficult to demonstrate, and, if it exists, it is 
 very slight. The only change of any import is a marked echo- 
 laha that he has developed. If one says, ' How old are you ? ' 
 he repeats over and over, 'You, you,' with a rising inflection 
 on the last letter. 'How is papa?' 'Papa, papa,' repeated and 
 repeated. Usually he takes the last word of the sentence that 
 he hears and echoes it, occasionally the last two words. Such 
 as, 'WlU you have an orange?' 'An orange, an orange,' he re- 
 peats — the ' an ' with great vigor and clearness of enunciation 
 
 ^ Collins, "The Faculty of Speech," pp. 257-258. 
 
i68 THE PSYCHOLOGY OF STAMMERING 
 
 and with a rising inflection on the last syllable of orange. Com- 
 plex words he occasionally attempts to echo, but he does not 
 succeed in so doing. There is still a degree of that condition 
 known as mind-blindness, but it is not so conspicuous as when 
 he was first seen." 
 
 Referring to echolalia, Bastian says:^ 
 
 "A defect of this kind (occurring in a woman who was hemi- 
 plegic from cerebral haemorrhage) has been recorded by Profes- 
 sor Behier.2 She was born in Italy, and had resided both in 
 Spain and France ; of the three languages she had thus acquired 
 she had completely forgotten the Itahan and Spanish, and had 
 only retained a most limited use of French. In this latter 
 language she only repeated like an echo the words pronounced in 
 her presence, without, however, attaching any meaning to 
 them. But in the case of a woman seen at the Salpetriere by 
 Bateman the mimetic tendency was much stronger. She even 
 reproduced foreign words with which she has never been famil- 
 iar." 
 
 Many cases are recorded in which patients reiterate 
 words without understanding them. Their failure to 
 understand words that they are themselves able to 
 enunciate is due to the involvement of other areas 
 besides the auditory centre. If the visual memory- 
 centre were destroyed in an eye-minded person, the vis- 
 ual associates of the word-images would be abolished, 
 and the words would be practically destitute of mean- 
 ing. Many words would retain their meaning by 
 
 1 "Aphasia and Other Speech Defects," p. 152. 
 * Gazette des Hopitaux, May 16, 1867. 
 
APHASIA 169 
 
 virtue of associated images of touch, hearing, etc. ; but 
 those that are usually associated with visual images 
 would fall meaningless upon the ears of the person 
 affected. Thus there may ensue a degree of word- 
 deafness from impairment of the visual memory- 
 centre. 
 
 This last condition, impairment of the visual 
 memory-centre (often with associated defects in the 
 auditory centre), is probably the defect that exists in 
 those few cases in which the patient is able to repeat 
 words spoken by another person and understand 
 them when he has himself pronounced them. The 
 auditory impressions are of themselves unable to 
 arouse the visual images in the partially damaged 
 centre; but when the auditory impressions are re- 
 inforced by the kinaesthetic sensations, the conjoint 
 stimuK are able to overcome the inertia of the damaged 
 cells. Another possible explanation is that the fibres 
 conveying stimuli from the auditory to the visual 
 centre are damaged, and that the stimuli reach the 
 visual centre indirectly through the kinaesthetic word- 
 centre. This explanation is open to the following 
 criticism : The kinaesthetic verbal images must be 
 present before the words can be orally produced. If 
 these images can be aroused by the sound of the words, 
 there seems no reason why they should not excite the 
 visual images directly, without first expressing them- 
 selves in oral speech. This criticism is not easily 
 
I70 THE PSYCHOLOGY OF STAMMERING 
 
 answered. The facts seem to be that the torpid 
 cells are excited only by the summation of stimuli 
 from two different sources. This principle of the 
 summation of stimuli is thoroughly estabHshed in 
 psychology ; and it is one that should be particularly 
 noted at this point, since we shall revert to it in suc- 
 ceeding chapters. Where a single stimulus is unable 
 to produce a given response — - a movement, the 
 arousal of a mental image, etc. — the response is often 
 produced by the cumulative effect of several different 
 stimuli. As already suggested, this probably happens 
 when the word-deaf person is able to understand 
 words after he has repeated them, — the word- 
 deafness being occasioned by torpidity of the general 
 visual centre as well as of the auditory verbal centre. 
 
 The Ability of an Aphasic Patient to Read Aloud 
 
 The principle of the summation of stimuli is ex- 
 emphfied in many aphasic (or amnesic) patients that 
 are able to assist themselves by visual stimuli. The 
 verbal centres may be too weak to permit the sponta- 
 neous recall of words, but they nevertheless respond 
 when there is an additional stimulus from the visual 
 centre. Thus it is sometimes found that a patient 
 can read aloud, though he cannot express himself 
 spontaneously. In some such cases it is probable that 
 the kinaesthetic verbal centre is excited directly from 
 the visual verbal centre without the intervention of 
 
APHASIA 171 
 
 the auditory centre. The images of articulatory 
 
 movements are then aroused directly by association. 
 
 Graves^ records an interesting case in which an 
 
 amnesic patient assisted himself by visual stimuli : 
 
 "The man was a farmer, aged 50 years, who had suffered 
 from a paralytic attack from which he had not recovered at the 
 time of observation. The attack was succeeded by a painful 
 hesitation of speech. His memory was good for all parts of 
 speech except noun-substantives and proper names ; the latter 
 he could not at all retain. This defect was accompanied by 
 the following singular peculiarity: he perfectly recollected the 
 initial letters of every substantive or proper name for which 
 he had occasion in conversation, though he could not recall to 
 memory the word itself. 
 
 "Experience had taught him the utility of having written 
 on manuscript a list of the things he was in the habit of calling 
 for or speaking about, including the proper names of his chil- 
 dren, servants, and acquaintances ; all these he arranged 
 alphabetically in a little pocket dictionary, which he used as 
 follows : if he wished to ask anything about a cow, before he 
 commenced the sentence he turned to the letter C, and looked 
 out the word 'cow,' and kept his finger and eye fixed upon the 
 word until he had finished the sentence. He could pronounce 
 the word 'cow' in its proper place so long as he had his eye 
 fixed upon the written letters ; but the moment he shut his 
 book it passed out of his memory and could not be recalled, 
 although he recollected its initial, and could refer to it when 
 necessary. He could not even recollect his own name unless 
 he looked out for it, nor the name of any person of his acquaint- 
 
 ^ Dublin Quarterly Journal, 1851. Case quoted by Bastian, 
 "Aphasia and Other Speech Defects," p. 148. 
 
172 THE PSYCHOLOGY OF STAMMERING 
 
 ance ; but he was never at a loss for the initial of the word he 
 wished to employ. " 
 
 In a somewhat similar case recorded by Aber- 
 crombie ^ the patient resorted to visual impressions 
 to assist himself in interpreting spoken language: 
 
 " His mental faculties were so entire that he was engaged in 
 most extensive agricultural concerns, and he managed them with 
 perfect correctness by means of a remarkable contrivance. He 
 kept before him in the room where he transacted business a 
 list of the words which were most apt to occur in his intercourse 
 with his workmen. When one of them wished to communi- 
 cate with him on any subject he first heard what the workman 
 had to say, but without imderstanding him further than to 
 catch the words. He then turned to the words in his written 
 list, and whenever they met his eye he understood them per- 
 fectly." 
 
 This is a case in which there must have been sum- 
 mation of stimuli — even if we suppose the patient to 
 have been a typical visile. He would find at best 
 only one or two words in his written list, but these 
 would add their weight to the auditory impressions 
 and assist in overcoming the inertia of those cells 
 whose torpidity isolated the acoustic sensations. 
 
 Lichtheim records a case^ in which the patient was 
 able to read fluently, although he was aphasic for 
 spontaneous speech. The patient could repeat quite 
 
 ^"Inquiry into the Intellectual Powers," 7th ed., p. 158. Cited 
 by Bastian, loc. cit., p. 158. 
 
 ^ Brain, 1885. Quoted by Bastian, loc. cit., p. 150. 
 
APHASIA 173 
 
 accurately, so it is plain that the cause of the speech- 
 disturbance was merely a diminished excitability 
 of the auditory centre. The patient was a medical 
 practitioner that had become aphasic as the result of 
 a carriage accident. There was paresis in the right 
 arm and leg. 
 
 "Speech was much affected; the first day the patient said 
 only 'Yes' or *'No,' but quite appositely. Gradually more and 
 more words returned, at first imperfectly. Whilst his vocabu- 
 lary was still very meagre, it was observed that he could repeat 
 everything perfectly. Soon after the accident he began to read 
 with perfect understanding. It was established beyond doubt 
 that he could read aloud perfectly at a time when he could 
 scarcely speak at all. The statements of his wife are most 
 positive and trustworthy upon this point, though he himself 
 does not recollect what took place just after the accident. She 
 states that after much difficulty in making himself understood 
 by gestures he obtained a newspaper, and to the great astonish- 
 ment of all present he began to read fluently. She herself 
 thought it most strange and inexplicable. . . . He could not 
 write voluntarily at all ; but this faculty returned slowly and 
 imperfectly, as did speech. On the other hand, he could, soon 
 after he left his bed, copy and write from dictation." 
 
 Bastian reports two similar cases in ''The Brain 
 as an Organ of Mind." ^ Both patients were 
 aphasic for spontaneous speech. Neither could 
 repeat very readily ; yet both could read with facihty, 
 — one, indeed, evincing no trace whatever of his 
 speech-defect when reading. In these cases it seems 
 
 ^ pp. 623-626. 
 
174 THE PSYCHOLOGY OF STAMMERING 
 
 probable that the kinaesthetic centre was excited 
 directly from the visual verbal centre. The patients 
 were probably articulo-moteurs in whom the motor 
 memory-centre had become fimctionally weakened. 
 The ' affection could scarcely have been one of the 
 auditory centre, for under such circumstances the 
 patients should have had less difficulty in repeating 
 spoken language. It is possible, too, that the pecuHar 
 symptoms may have been due to an interruption in 
 the audito-kinaesthetic association-tract.^ So long as 
 the visuo-kinaesthetic tract remained uninjured, the 
 patients might be able to speak when assisted by visual 
 associations even though they were imable to speak 
 spontaneously. 
 
 Interjectional Speech 
 
 Under strong emotional excitement aphasic patients 
 often give expression to words or phrases of an inter- 
 jectional nature.^ This sometimes occurs even when 
 the patient is otherwise completely mute. Ballet^ 
 cites the case of a distinguished lady whose sole 
 vocabulary consisted in the expression Sacre nom de 
 
 ^ In naming association-tracts, the centre is given j&rst from 
 which the stimulus is supposed to emanate. Thus, activity flows 
 from the auditory to the kinaesthetic centre through the atidito- 
 kincEsthetic tract. It flows in the reverse direction through the 
 kincBsthetic-anditory tract. 
 
 2 See p. 1 24. 
 
 '"Le langage int6rieur et I'aphasie," 2d ed., pp. 1 19-120. 
 
APHASIA 175 
 
 Dieu! He states also that the speech of the poet 
 Baudelaire was limited to the expletive Cre nom! ere 
 nom! Numerous cases of like nature are on record. 
 
 The explanation for this exclamatory speech may be 
 found in the greater intensity of the emotional stimu- 
 lus. Just as several normal stimuH acting concur- 
 rently may produce a response in torpid cells, so a 
 single stimulus may produce a response if its intensity 
 equals that of the sum of the several stimuli. 
 
 It has been suggested that familiar and emotional 
 expressions (''degraded" speech) are represented in 
 the right hemisphere of the brain. The assumption is 
 rather gratuitous ; and the fact that it disposes of a 
 few difficulties is not sufficient warrant for its accept- 
 ance. It seems more reasonable to suppose that the 
 different mental images are represented in the cor- 
 tex by a plurality of cells, and that some of the cells 
 escape damage. If a few of these undamaged cells 
 were strongly excited, the effect would be the same as 
 though a greater number of cells were excited to a less 
 degree. 
 
 It is manifest that a mental image becomes more 
 deeply ingrained through the repetition of a sensation. 
 Even when there are extensive organic lesions in the 
 cerebral centres, the memory of more famihar experi- 
 ences frequently endures. An aphasic patient may be 
 practically mute, and yet be able to give expression to 
 such famihar words as yes and no. Often an agraphic 
 
176 THE PSYCHOLOGY OF STAMMERING 
 
 patient can write his own signature, and often a word- 
 blind patient can read his own name. Frequently the 
 amnesic polyglot patient loses his memory for one or 
 more languages, while the memory for his mother- 
 tongue remains unimpaired. One cannot for a mo- 
 ment suppose that the destructive processes of disease 
 respect the conscious content of a cell, — that the 
 cell presiding over no is less Kable to destruction 
 than the cell presiding over the word negative. But, 
 since the more famihar expression is less readily 
 forgotten, the only alternative is to suppose that it is 
 more extensively represented in the cortex. If this is 
 the case, there can be no doubt that repetition brings 
 new cells into activity. 
 
 When a lesion is inflicted upon one of the centres in 
 the memory-hemisphere of the brain, the function of 
 the centre is in some instances vicariously assumed by 
 the corresponding centre of the uninjured hemisphere. 
 This is most likely to occur in early childhood, but 
 with persistent education it appears to occur in some 
 instances in later life. The transference of function is, 
 of course, effected by reeducating the patient. The 
 word-concepts are not bodily transferred to the un- 
 injured hemisphere of the brain; they have to be 
 organized afresh through the reestablishment of 
 associations. If the auditory centre in the left hemi- 
 sphere happens to be injured, the cells in the right 
 
APHASIA 177 
 
 hemisphere must become active before the auditory 
 memory can be reestablished. But, for the auditory 
 images to possess associations of meaning, it is evident 
 that these new auditory cells must be in physiological 
 connection with memory-cells in other centres of the 
 brain. These centres are probably not transferred 
 from the old hemisphere. They are connected with the 
 new hemisphere by transverse fibres ; hence the organic 
 association may be transverse. It is quite clear that 
 the new associations can be established only by asso- 
 ciations in actual experience, — and this, too, even 
 when the memory-cells of the undamaged centres are 
 not replaced by new ones. Thus the patient has 
 practically to be educated anew. The process of re- 
 education is a slow and laborious one. Except in the 
 case of the very young child, the transference of func- 
 tion hardly ever takes place spontaneously. 
 
 The question may suggest itself as to whether it 
 would not be desirable for one to strengthen the weaker 
 image-types lest the more dependable images should 
 at some time become impaired. It is doubtful, how- 
 ever, whether the mental images can be developed to 
 any great extent. Some psychologists have asserted 
 that the weaker images can be developed by more 
 frequent use and by the multiplication of associations, 
 but the matter is really open to question. The subject 
 will be discussed later in another connection. But, 
 
178 THE PSYCHOLOGY OF STAMMERING 
 
 assuming for the time that mental images can be de- 
 veloped, it is certain that the limit of development 
 would be low for a type of imagery that does not 
 freely and spontaneously assert itself. On the con- 
 trary, the Hmit of development would be high for the 
 type of imagery that predominates in one's thinking. 
 Nevertheless, a limited development of the rudimen- 
 tary imagery mi^ht be considered more desirable than 
 no development at all. The trouble, however, is this : 
 One does not possess the ability and intelligence to 
 direct one's thinking during that period of Hfe when 
 the mind is in the plastic state. By the time the 
 necessary ability and intelligence are acquired, the 
 mental characteristics are practically established ; and 
 though it may be possible to strengthen the weaker 
 imagery to a limited extent, the salient mental traits 
 will be unalterable. 
 
 Whatever may be the degree to which mental 
 images can be developed, it is certain that it would be 
 of little benefit for one to strengthen the weaker im- 
 ages merely as a safeguarding measure in case of depri- 
 vation of the more dependable faculties. Cerebral 
 lesions are of rare occurrence, and a person suffering 
 such injuries is usually unequivocally hors de combat. 
 When the lesion is not fatal to Hfe or intellect, there 
 occurs spontaneous development of those faculties 
 that remain unimpaired, and they then reach a degree 
 of efficiency that would formerly have been unattain- 
 
APHASIA 179 
 
 able. Considering the other side of the question: 
 should some misadventure result in the obliteration of 
 a carefully strengthened type of imagery, then the 
 ensuing loss would be far more disastrous than would 
 have been the case if the imagery had remained unde- 
 veloped. However, cerebral lesions are too infrequent 
 to warrant the adoption of psychological prophylactic 
 measures ; and any development of imagery that may 
 be possible will be resorted to for utilitarian purposes 
 and not as a safeguarding measure against an unlikely 
 
 contretemps. 
 
 Causes of Aphasia 
 
 The causes of aphasia are somewhat arbitrarily 
 differentiated as functional and organic. In reahty 
 there is no such division, for functional defects are 
 in themselves due to organic causes ; though the 
 abnormal organic conditions may not be visible to the 
 naked eye. Strictly speaking, even chemical changes 
 are organic. The classification of defects as functional 
 and organic is one only of convenience. 
 
 Among the most obvious of the organic causes of 
 aphasia is laceration of the cerebral tissue. This is 
 usually due to penetration of the skull by some foreign 
 body. A spUnter of bone may itself press upon the 
 brain or may lacerate the cortex. This sometimes 
 happens when the cranium is struck by a dull body, — 
 as the result of a fall, for instance. Sometimes aphasia 
 occurs from these causes when there is no fracture of 
 
i8o THE PSYCHOLOGY OF STAMMERING 
 
 the skull. In such cases there is laceration of the finer 
 cerebral fibres, or the disturbance is induced indirectly 
 by the mental shock. ^ Further organic causes are 
 cerebral tumors or abscesses, inflammation of the brain, 
 softening of the brain (often due to obstruction of the 
 cerebral blood-vessels) , rupture of the cerebral vessels, 
 tuberculosis of the meninges, etc. 
 
 Among the so-called functional causes of aphasia 
 are temporary obstruction of the cerebral vessels, 
 spasm of the vessels, etc. Cerebral congestion may 
 Hkewise induce aphasia. Aphasia is often due to 
 nervous exhaustion following overwork, mental fa- 
 tigue, worry, etc. Another frequent cause is a toxic 
 condition of the blood — due to lead or copper poi- 
 soning, poisoning by stramonium, belladonna, etc. 
 A toxic condition may likewise be caused by snake- 
 bites, acute alcohoKsm, bromide intoxication, excessive 
 tobacco-smoking, and — when the poison is engendered 
 within the system — by diabetes, gout, Bright's disease, 
 typhoid fever, smallpox, measles, etc. In general, it 
 may be said that aphasia can be induced by any 
 cause that brings about an abnormal condition in the 
 cerebrum. 
 
 ^ See p. 226. 
 
CHAPTER VII 
 
 STAMMERING 
 
 We come now to the consideration of stammering.^ 
 Our first task will be to ascertain the cause of this 
 speech-defect. For convenience, we shall consider 
 first the theory of its cause that finds at the present 
 time the widest acceptance among pathologists. 
 This theory supposes that stammering is due to a de- 
 lay in vocalization ; in other words, to the stammerer's 
 inabihty to produce voice. ^ The theory was first 
 promulgated by Dr. Neil Arnott, in 1827, in his 
 
 ^ The word stammering is used in this work generically unless an 
 antithesis between stuttering and stammering is expressed. 
 
 It will be seen later that the distinction between stammering and 
 stuttering is an artificial one. Skittering is usually defined as a form 
 of defective speech manifesting itself in repetition of the initial 
 consonant. Staynmering is defined as a form of a defective utterance 
 characterized by strangulatory and compressive effort — or as any 
 minor form of speech-hesitation that is not stuttering. Much con- 
 fusion has arisen in these definitions through English and American 
 authors translating the German word stammeln {Idling or haby talk 
 in its milder forms) as stammering. 
 
 2 The pathologist regards this phenomenon more as the form in 
 which stammering manifests itself. The "inability to vocalize" is 
 represented as the cause rather by ignorant quacks, who guard this 
 as one of the secrets of their profession. 
 
 181 
 
i82 THE PSYCHOLOGY OF STAMMERING 
 
 *' Elements of Physics." Later the theory was sup- 
 ported by Merkel in Germany.^ Merkel no doubt 
 advanced the theory independently, as many other 
 writers have done since the time of Arnott. 
 Wyllie expresses the theory as follows : ^ 
 
 "In the common variety of stammering the speaker neg- 
 lects the laryngeal mechanism ; and, when no speech is emitted, 
 he unwittingly throws increased force into the wrong quarter, 
 \dz., the oral mechanism, whose nerve centres thus become 
 surcharged with energy, which may overflow into other centres 
 and produce spasmodic complications. . . . 
 
 "That the defect of speech in the common variety of stam- 
 mering is due to Delayed Action of the laryngeal or vocal 
 mechanism in attacking the first syllables of words, is an old 
 proposition ; and is also to the present day maintained by the 
 best writers on the subject." 
 
 Bastian holds the same view concerning the cause of 
 stammering : ^ 
 
 " Stammering is a hesitating, spasmodic speech defect often 
 beginning about the fourth or fifth year, and much more com- 
 mon in boys than girls, which is due not so much to a want of 
 precision or coordination in the action of the several groups of 
 muscular elements constituting the oral articulatory mechan- 
 ism, but rather to a want of accord between the action of the 
 laryngeal and the oral speech mechanisms. There is mostly a 
 lagging action of the former." 
 
 * "Schmidts Enzyklopadie der ges. Medezin," Bd. VI, 1844. 
 2 "Disorders of Speech," pp. 2-3. 
 
 * "Aphasia and Other Speech Defects," p. 58. 
 
STAMMERING 183 
 
 It IS easy enough to show that the difficulty of the 
 stammerer is in some way connected with the pro- 
 duction of the vowel, and that the consonant is not 
 the obstacle, as would appear to the casual observer. 
 The arguments in support of this proposition are as 
 follows : 
 
 a. When the stammerer falters on a continuous 
 consonant, he usually prolongs the consonant for 
 several seconds. He stammers on the word six, let 
 us say, and produces the s continuously. Now, the 
 fact that he is producing the ^ shows clearly that he 
 has no difficulty in articulating the consonant. His 
 difficulty is to produce the vowel ; and as soon as the 
 vowel is uttered, the sibilation stops. In a mono- 
 syllabic word that has no final consonant — the word 
 so, for example — the word is complete as soon as the 
 vowel is enunciated. The same arguments apply in 
 every case of continuous stammering. The diffi- 
 culty is not with the consonant, since this is usually 
 produced to excess. The consonant is prolonged only 
 because the vowel is delayed. 
 
 b. In stuttering, the consonant is produced repeat- 
 edly. The speaker attempts to say ten; but he pro- 
 duces a series of fs and the word becomes t-t-t-ten. 
 Since the t is repeatedly articulated, the difficulty 
 cannot lie with the consonant. The t is repeated only 
 because the succeeding vowel refuses to appear. 
 (Unlike the letter s, the / cannot be produced con- 
 
i84 THE PSYCHOLOGY OF STAMMERING 
 
 tinuously; hence it is repeated when the vowel is 
 delayed.) The same argument appUes in every case 
 of stuttering upon explosive consonants. The con- 
 sonant is repeated; hence there is no obstruction to 
 its articulation. The repetition is occasioned only by 
 the delay in the appearance of the vowel. 
 
 c. If the stammerer's difficulty lay with the articula- 
 tion of the consonant, he would stammer quite as much 
 at the end of a word as he does at the beginning. The 
 stammerer, however, never hesitates at the end of a 
 word: 
 
 "No stammerer has ever faltered in attaching the consonant 
 to the vowel in such syllables as ad, ek, ik, oh, for the reason 
 that it is quite impossible for him to do ^." ^ 
 
 d. That the difficulty does not He with the conso- 
 nant, but with the vowel, is borne out by the fact that 
 stoppage often occurs when the word begins with a 
 vowel. The stammerer may ffiid the word any as 
 difficult as many, and angle as difficult as dangle. 
 When he stammers on the initial vowel, there can be 
 no question concerning difficulty with consonants. 
 Often there is no consonant at all in the word, and the 
 difficulty appears with such words as / and a. 
 
 e. The stammerer rarely has difficulty in singing. 
 But song differs from speech chiefly in the manner in 
 which the vowels are produced ; while there is mani- 
 
 ^Merkel, "Anthropophonik," p. 908. (Quoted by Denhardt, 
 "Das Stottem eine Psychose," p. 28.) 
 
STAMMERING 185 
 
 festly no radical change in the consonants. The 
 absence of the stammerer's impediment in song 
 indicates, then, that the vowels occasion the difSculty 
 in speech. 
 
 From these arguments it is evident that the stam- 
 merer's trouble is due to the delay of the vowel. 
 Hence the theory arises that the stammerer is unable 
 to produce voice, — that his difficulty is due to a lag- 
 ging of the laryngeal action. 
 
 Unfortunately this theory does not take account of 
 all the facts, and the facts that it disregards are 
 sufficient to refute it. If the stammerer's impedi- 
 ment were due solely to his inability to produce voice, 
 then all trace of the impediment should vanish as 
 soon as he begins to whisper, for in whispering no 
 phonation occurs. But actual experience shows that 
 the impediment persists in approximately two cases 
 out of three (Hermann Gutzmann).^ This is con- 
 clusive evidence that the difficulty does not lie with 
 the production of voice, as such. 
 
 A second fact shows just as conclusively that the 
 difficulty is not one of vocalization. One often stam- 
 mers on continuous sonant consonants, and in this case 
 there is continuous production of voice. In endeavor- 
 ing to pronounce the word many, the stammerer may 
 produce the m slssl continuous humming sound. Here 
 
 ^ Kussmaul, "Storungen der Sprache," 4th ed., p. 352. 
 
i86 THE PSYCHOLOGY OF STAMMERING 
 
 there is certainly no delay in the action of the 
 larynx. 
 
 Still another fact bears witness that the stammerer's 
 difficulty is not one of phonation. The stammerer 
 often vocalizes when stammering or stuttering upon a 
 vowel. One writer says, when speaking of repetitive 
 utterance : ^ 
 
 "It is by no means uncommon for a stammerer to go through 
 the same process of repetition when trying to pronounce a 
 word commencing with a vowel." 
 
 Kreutzer, in endeavoring to defend the thesis that 
 stammering is a "refusal of the voice," writes as fol- 
 lows : 2 
 
 "If the answer is made that frequently a stutterer repeats 
 a vowel, as E-E-E-E-E in Emil, A- A- A- A- A in Adolf, etc., and 
 that therefore I cannot say that the 'E' and the 'A' are the 
 obstacles, I must still maintain my ground, for a closer examin- 
 ation soon reveals that all the stutterer vocalizes is only a part 
 of the ' E ' and the ' A, ' and that the vowels are never perfectly 
 formed." 
 
 These facts clearly show that the stammerer's 
 difficulty is not one of phonation. But they show 
 further that his difficulty is in some way connected 
 with the production of the vowel. When the stam- 
 
 * Mrs. Emil Behnke, "On Stammering, Cleft-Palate Speech, Lisp- 
 ing," p. lO. 
 
 2"Kreutzer's Method" {The Voice, 1881, Vol. HI, p. 175), 
 
STAMMERING 187 
 
 merer hesitates while whispering, he produces the 
 initial consonant repeatedly or continuously, and is 
 unable to pass to the vowel, — or he may hesitate on 
 a vowel if it begins a word. When, in speaking aloud, 
 the stammerer falters on a continuous sonant conso- 
 nant, he produces the consonant as continuous voice, 
 but is unable to pass to the vowel. When he vocalizes, 
 but does not complete, an initial vowel, the difficulty 
 is in some way connected with the vowel itself. 
 
 Now, since the stammerer's difficulty is to produce 
 the vowel, and is not to produce voice per se, it is 
 evident that his difficulty must be to produce the 
 vowel-color or vowel-quality. The stammerer^ s difficulty 
 is transient auditory amnesia: he is unable to recall 
 the sound-image of the vowel that he wishes to enun- 
 ciate. This, then, is the thesis of the present mono- 
 graph. 
 
 The stammerer is an audito-moteur. He rehes for 
 his speech-cues upon both kinaesthetic and auditory 
 images. When he stammers in enunciating a word, it 
 is because there is complete failure of the auditory 
 image. His futile struggles with the initial consonant 
 are directed solely by his kinaesthetic imagery, but 
 he cannot pass to the vowel because he cannot recall 
 its sound, its peculiar or characteristic quahty, — in 
 short, the vowel-color. When he attempts to speak 
 the word ten, he produces the / entirely by feeling ; but 
 he cannot mentally hear the sound e, and is hence 
 
i88 THE PSYCHOLOGY OF STAMMERING 
 
 unable to proceed. His mental imagery might be 
 diagrammed as follows — T-N ; with the capitals 
 representing kinaesthetic images of articulatory move- 
 ments, and the hyphen representing a mental hiatus. 
 It would be more accurate to represent the mental 
 image as T-, simply; the consonant representing a 
 kinaesthetic image, and the hyphen representing an 
 auditory blank. The kinaesthetic image of the N does 
 not appear during the stammerer's futile efforts to 
 articulate. The diagram T-N represents, however, 
 the verbal image as it occasionally appears in silent 
 thought. 
 
 The assumption is not made in regard to the stam- 
 merer's normal verbal imagery, that he has an auditory 
 image only of the color of the vowel. Many stam- 
 merers may have an auditory image of the entire 
 word, but so long as the image fails to appear during 
 speech, stammering must inevitably result. The 
 stammerer's kinaesthetic image of the initial articula- 
 tory movements would permit him to struggle with 
 the word, but till the auditory image arose in his 
 mind he could not complete it. It is, however, 
 primarily the failure of the auditory vowel-ircid^ge that 
 occasions the stammerer's difficulty, for the auditory 
 impression of the consonant is generally supplied by 
 the actual stammering. 
 
 The theory that stammering is occasioned by the 
 speaker's inability to recall the auditory image of the 
 
STAMMERING 189 
 
 vowel-color ^ is borne out by practically every mani- 
 festation of the defect and every phenomenon con- 
 nected with it. 
 
 In the simplest form of stammering there occurs 
 merely a pause between the consonant and the vowel ; 
 the pause, of course, being occasioned by the speaker's 
 inabiHty to redintegrate the necessary auditory image. 
 Kussmaul says of this form of stammering : ^ 
 
 "There are slighter forms of the impediment in which the 
 defect manifests itself only in undue prolongation of the con- 
 sonants g, k, w, etc. In our younger days we were more amused 
 than was seemly at the speech of an old nurse, who spoke some- 
 what as follows : ' K-h-ommen Sie endUch ? Der K-h-affee 
 ist schon etw-h-as k-h-alt.'" 
 
 The defect, it will be seen, is not a prolongation of 
 the initial consonant, but simply a delay in the appear- 
 ance of the vowel. The defect differs from ordinary 
 stuttering or stammering only in the fact that the 
 initial consonant is not repeated (stuttering) when the 
 vowel-image fails to appear, and that there is no at- 
 tempt to force the utterance of the word by undue 
 pressure upon the consonant (stammering).^ 
 
 In severe cases of stammering it quite frequently 
 
 ^ It will be seen later that auditory amnesia is not the primary 
 cause of stammering when the disturbance has been induced by 
 imitation. 
 
 2 "Storungen der Sprache," 4th ed., pp. 246-247. 
 
 ' In stammering, the articulative efifort is, of course, occasioned 
 by the inordinate expression of the kinaesthetic image. The stam- 
 
igo THE PSYCHOLOGY OF STAMMERING 
 
 happens that the speaker, after fearful struggle with 
 a word, gives utterance to an entirely inappro- 
 priate vowel. This fact shows that the conditions 
 affecting the vowel-image are abnormal. Through 
 defective internal audition the wrong auditory vowel- 
 image is invoked, or no auditory image is invoked and 
 the vowel is produced kinaesthetically. Kussmaul has 
 remarked this mutilation of sounds in syllable-stimi- 
 bling and "stammeln" — forms of speech-defects that 
 sometimes coexist with stammering:^ 
 
 "With the syUable-stumbler as well as the 'stammler,* 
 one sees quite frequently an interchange of related sounds; 
 ii and i, u and e, oe and e, u and o, hard and soft consonants, 
 etc. Or the preceding or succeeding consonant leads to the 
 use of the wrong vowel in the middle of the word because the 
 correct vowel involved a too diflScult transition." ^ 
 
 Hunt also refers to the occurrence of this phe- 
 nomenon in cases of stammering:^ 
 
 "Let us take a simple case: when the stutterer cannot pro- 
 duce a vowel sound, — a vowel stutterer. In this case two ac- 
 tions are requisite; first, the air must be expelled from the 
 
 merer finds himself checked at the consonant when the auditory 
 image fails to appear. He struggles with the consonant largely 
 through ignorance of the conditions. 
 
 ^ Kussmaul considers the cause of stammering to be "a congenital 
 irritability or weakness of the syllable coordinating apparatus" 
 (loc. cit., p. 247). 
 
 2 Kussmaul, loc. cit., pp. 220-221. 
 
 •"Stammering and Stuttering," 7th ed., p. 239. 
 
STAMMERING 191 
 
 lungs ; next, the vocal cords in the larynx must be in a posi- 
 tion to vibrate. The difficulty in this case is caused by the 
 inability to associate the action of the muscles of expiration with 
 that of the vocal cords. ... To take a more compUcated case : 
 The stutterer can produce the sound, but cannot articulate it 
 so as to form the desired vowel. Here the lungs act normally, 
 but the disharmony lies in the coordination of the action of the 
 vocal with the articulating apparatus. For instance, take the 
 word how. His lungs being supposed to act normally, he sounds 
 the aspirate h and a part of the vowel. Here we must observe 
 that the sound ow in the above word is a compound sound — 
 au and 00.^ He produces the sound aii, but fails in conjoining 
 it with the succeeding sound 00. This requires the retrac- 
 tion of the tongue and the protrusion of the Ups. The same 
 difficulty of coordination is visible here. A stutterer of this 
 kind, unless his respiration is at fault, in which case no sound 
 can be produced, finds no difficulty in producing the pure 
 vowel sound, neither has he any difficulty in the movements 
 of the hps and tongue when not speaking ; but when these are 
 required to be associated for the formation of speech-sounds, 
 he hesitates and stutters." 
 
 On another page the same writer says, after re- 
 ferring to another form of stammering : ^ 
 
 "In others, again, the vowel can be formed in the larynx, 
 but the stutterer is unable to complete its formation, or conjoin 
 it with a consonant, by the intervention of the articulating 
 organs. This is especially the case with the sounds i, a {ay), 
 ow, etc." 
 
 ^ The elements of the diphthong ow can be more accurately rep- 
 resented as ah-00 (as in far and who), or in Bell's Visible Speech 
 symbols as J^ or 3^. — C. S. B. 
 
 2 Hunt, loc. cit., p. 246. 
 
192 THE PSYCHOLOGY OF STAMMERING 
 
 Ssikorski likewise describes the distortion of the 
 vowel, — and, like Hunt, has a physiological explana- 
 tion for it : ^ 
 
 " For example, the vowel u somtimes sounds more like o — 
 this because the lips were not rounded and protruded to the posi- 
 tion for u when the spasm ^ appeared, but were merely moving to- 
 ward this position. The same phenomenon may be observed 
 in the production of other sounds as well." 
 
 Beesel, Colombat, and other writers also describe 
 this imperfect production of the vowel. 
 
 When an inappropriate vowel replaces the correct 
 one, there is either a wrong auditory image in the mind, 
 or there is no auditory image and the vowel is pro- 
 duced kinaesthetically. When a diphthongal vowel is 
 only partially produced, there is either failure of part of 
 the auditory vowel-image, or — what is more likely — 
 there is failure of the whole image, and part of the 
 vowel is motorially initiated. As a rule, the part of 
 the vowel that is produced is entirely incorrect. 
 
 Another striking phenomenon shows conclusively 
 that the stammerer's dilS&culty lies with the auditory 
 vowel-image. Often stammering occurs only when 
 particular vowels appear in the word. The nature of 
 the initial consonant then has little effect upon speech. 
 This fact has been noted by Denhardt : ^ 
 
 * Ssikorski, "Ueber das Stottem" (from the Russian), p. 75. 
 2 These spasms will be discussed later (pp. 263 JBF.). 
 
 • Rudolph Denhardt, "Das Stottem eine Psychose," p. 31. 
 
STAMMERING 193 
 
 " Sometimes one meets stammerers for whom particular con- 
 sonants are difficult only when they occur in conjunction with 
 particular vowels. Thus, ko, ku, and tu may be difficult ; but 
 not ka and ia." 
 
 Stekel reports a case of this kind : ^ 
 
 "The third case that I had occasion to handle concerns a 
 gentleman that was unable to pronounce words containing the 
 vowel a. Words in which the a occurred twice were especially 
 difficult. It cost him a great deal of effort to pronounce such 
 a word as cataract, and it was extremely painful for him to em- 
 ploy such words in conversation. At a social affair he once 
 mispronounced the word papa as popo." 
 
 It will be noticed that in this case there was diffi- 
 culty with particular vowels, and sometimes mutila- 
 tion of the vowels when they were finally pronounced. 
 
 As a rule, particular vowels are difficult only be- 
 cause their auditory images are more difficult to recall. 
 The most difficult vowels for the stammerer to re- 
 dintegrate are those that are least definite and tangible 
 in their coloration. For this reason stammering 
 occurs with far greater frequency on the short vowels 
 than it does on the long vowels.^ The stammerer is 
 less Hkely to have trouble with the word light than 
 with the word lit. This is because the long vowel i is 
 clearer and more tangible than the short vowel t. 
 
 * "Nervosa Augstzustande und ihre Behandlung," p. 233 
 
 2 Pitman gives the long vowels as ak, a, e, aw, 0, do (pa, may, we^ 
 
 all, go, too), and the short vowels as i, S, i, d, it, 66 {that, pen, is, not, 
 
 much, good). 
 
194 THE PSYCHOLOGY OF STAMMERING 
 
 The auditory image of the former vowel is more read- 
 ily redintegrated. It is, as it were, more definite and 
 substantial, and the mind can better recall it. An 
 analogy may be drawn between vowel-color and color 
 as it actually appeals to vision. The long vowel in 
 light might be compared to a vivid and definite green, 
 and the short vowel in lit to an intangible and indefi.- 
 nite gray. The vowel in hate might be characterized 
 as red, and the vowel in hat as indefinitely brown. 
 The long vowels are found to have more definite color 
 as they fall upon the ear, and the distinction is even 
 more marked as they are recalled in auditory imagery. 
 The long vowel may be mentally heard with con- 
 siderable clearness when the short vowel absolutely 
 refuses to rise in consciousness. When this vowel- 
 sound fails to appear, the stammerer can no more 
 pronounce it than the musician can tune an instru- 
 ment from a key-note that he has not heard. 
 
 As already stated, the short vowels fail more fre- 
 quently than the long vowels; hence they afford the 
 stammerer greater difi&culty. This fact has been rec- 
 ognized by a number of writers. Dr. Findley says : ^ 
 
 "Syllables with a short vowel are much more difficult to 
 utter than those with a long or broad sound ; thus it is much 
 easier to say hate, heat, hite, danger, than to say hat, het, hit, death. 
 In the case of uttering the different consonants, there is no 
 uniformity, some being more difficult to one, others to another, 
 
 ^ The Voice, April, 1885 (article, "Stammering"). 
 
STAMMERING 195 
 
 generally the mutes give more trouble than the semi vocals. 
 In this respect the experience of the same person is not 
 uniform." 
 
 Itard, who wrote nearly a hundred years ago, says 
 of the matter : ^ 
 
 "A good deal also depends on the vowel with which the 
 consonant is combined ; thus stammerers find less difi&culty in 
 articulating co than ca." 
 
 In 1830, Hervez de Chegoin wrote as follows i^ 
 
 "It is possible to convert the difficult word baliveau into a 
 very easy one without changing the consonants b, /, and v, but 
 by changing the vowels that follow b and v. To illustrate, be 
 replaces ba, li remains unchanged, and vier takes the place of 
 veau. The word thus becomes belivier, a word that would cause 
 me no difficulty, though I hesitate on the word baliveau.'' 
 
 It will be noticed that in this case the short and 
 intangible vowels have given place to others of a more 
 definite coloration. 
 
 Wyneken says in regard to long and short vowels : ^ 
 
 "I may remark that according to my own experience these 
 consonants are especially difficult when combined with a short 
 vowel or diphthong (au, ai, eu). Most stammerers find the 
 words Bann, Pap pel, and Kamm more difficult than Bahn, 
 Papel, and Kam. And even at the beginning of a word the short 
 vowels and diphthongs occasion stammering more frequently 
 
 ^ "M6moire sur le b6gaiement" (Journ. universel des sciences 
 midicales, 181 7). 
 
 2 "Recherches sur les causes et le traitement du b^gaiement," p. 8. 
 ' "Ueber das Stottem und dessen Heilung," p. 6. 
 
196 THE PSYCHOLOGY OF STAMMERING 
 
 than the long vowels. Thus the words Otto and Ammen are 
 more difficult than the words Otho and Amen." ^ 
 
 Statements similar to those quoted above are made 
 by most writers on the subject of stammering. 
 
 It is interesting to note that the stammerer, when 
 employing synonyms for difficult words, usually re- 
 places a short vowel by a long one. It often happens 
 that the initial consonant is retained; so it is quite 
 evident that the consonant itself presents no difficulty. 
 Thus the stammerer says saneness instead of sanity; 
 gamester instead of gambler ; dine instead of take din- 
 ner; etc. In these cases there is a change from a short 
 to a long vowel, though the initial consonant remains 
 unaltered. The change is made from the short vowel 
 to the long one because the long vowel has a more 
 distinct coloration, and hence can be more readily 
 recalled. 
 
 There is another striking phenomenon that shows 
 clearly the relation between stammering and auditory 
 amnesia. The stammerer can almost invariably 
 articulate a word as soon as some one pronounces it 
 for him. The explanation is, of course, that the 
 acoustic impression supplies the refractory auditory 
 
 1 The writer can scarcely agree with Wyneken that diphthongs 
 occasion stammering more frequently than the long vowels — though 
 they frequently occasion a more conspicuous form of stammering 
 for the reason that the speaker can commence them but cannot finish. 
 Many of the long vowels are themselves diphthongs, but the short 
 vowels are invariably monophthongal. 
 
STAMMERING 
 
 197 
 
 image from without, and that the stammerer need not 
 then struggle to arouse the image in his mind. After 
 he has heard the word that he was trying to enunciate, 
 he is able to pronounce it while the primary acoustic 
 image remains clear. As soon as this primary memory 
 fades, he stammers on the word as before. 
 
 The abihty of the stammerer to repeat has been 
 noted by practically every writer on the subject of 
 stammering. Kussmaul says : ^ 
 
 "The impediment ceases as soon as some one pronounces 
 the refractory word by way of assistance." 
 
 Dr. Rafael Coen makes the following observation : ^ 
 
 "I spoke the word after the stutterer, and immediately he 
 could say it without the least hesitation. This is a fact that I 
 have observed in all stutterers [stammerers] and which enables 
 me to distinguish stuttering [stammering] from kindred speech- 
 affections." 
 
 And thus Denhardt : ^ 
 
 "As a rule, the stammerer can repeat without hesitation a 
 word that he hears pronounced. One observes this very fre- 
 quently when he pronounces the word for the stammerer in 
 order to put an end to his painful struggles. One pronounces 
 the diflScult word himself, expecting the stammerer then to pro- 
 ceed. But before continuing his conversation the stanunerer 
 almost invariably articulates the refractory word, — and this 
 too without the sHghtest difficulty; although only a moment 
 
 ^ "Storungen der Sprache," 4th ed., p. 244. 
 
 2 The Voice, Vol. VII, p. 22 (article, "Stuttering"). 
 
 • "Das Stottem eine Psychose," p. 51. 
 
-198 THE PSYCHOLOGY OF STAMMERING 
 
 before, the word seemed checked by insuperable obstacles. 
 As a rule, the spasm is suspended the very moment the stam- 
 merer hears the recalcitrant word from the lips of his compan- 
 ion, and it gives place at once to the appropriate and thoroughly 
 normal conformation of the speech-organs." 
 
 This ability of the stammerer to repeat is attributed 
 by Denhardt to the reassurance the speaker derives 
 from the knowledge that he is already understood. 
 Kussmaul offers a similar explanation. Undoubtedly 
 the reassurance mitigates the stammerer's difficulty; 
 but this is not the chief reason for his fluency, for he fre- 
 quently stammers when he knows that he is understood, 
 and he stammers sometimes when he is alone. The real 
 explanation is that the auditory impression furnishes 
 the mental image that was not previously forth- 
 coming. When the auditory impression is supplied, 
 the stammerer speaks with fluency whether his words 
 are anticipated or not. The following remark by 
 Wyneken bears out this statement, and the reader will 
 agree that it is replete with significance : ^ 
 
 "I knew a schoolboy that was unable to recite his lesson 
 unless a companion near-by first pronounced the words quietly 
 for him." 
 
 It is self-evident that the difficulty in a case of this 
 kind must be auditory amnesia. 
 
 It will be remembered that in the preceding chapter 
 (pp. 166 ff. and 172-173) several instances were cited 
 
 ^"Ueber das Stottern und dessen Heilung," p. 19. 
 
STAMMERING 199 
 
 in which patients suffering from auditory amnesia were 
 able to repeat words without the slightest difficulty even 
 when their speech-disturbances were so severe that they 
 could utter very few words spontaneously. Stam- 
 mering is a form of auditory amnesia ; thus it is not 
 surprising that it should exhibit this same phenomenon. 
 Ball records a case ^ that shows clearly the effect of 
 auditory amnesia. The patient developed the dis- 
 turbance after exposure to cold. There was complete 
 aphasia for several weeks, but gradually the patient 
 began to reacquire command of language. "He had 
 partial word-deafness from the commencement ; and 
 later on he said, 'The words I can't pronounce are 
 the words I can't hear.'" At the necropsy a lesion 
 was found covering the inferior parietal lobule and 
 the posterior part of the first temporal convolution. 
 It is evident from the location of the lesion that the 
 auditory word-centre was affected. The patient was 
 unable to understand particular words because the 
 auditory cells subserving them were impaired. But 
 on account of this impairment he could not invoke 
 the auditory images, and hence was unable to pro- 
 nounce the words in question. This phenomenon 
 precisely illustrates the amnesic condition that oc- 
 casions stammering ; though in stammering, the 
 amnesia is transitory and word-deafness is little in 
 
 ^Quoted by Bastian, "Aphasia and Other Speech Defects," pp. 
 327 f. 
 
200 THE PSYCHOLOGY OF STAMMERING 
 
 e\'idence. The stammerer's difficulty is less severe 
 because the cerebral disturbance is usually functional 
 rather than organic. 
 
 The ability of the stammerer to repeat words that 
 are pronounced for him finds its parallel in his ability 
 to repeat a word that he finally succeeds in uttering 
 for himself. When the auditory image is at last 
 redintegrated, the stammerer pronounces the desired 
 word, the sound of the word comes back through the 
 ear, and the auditory image is strengthened. The 
 result is that the stammerer can repeat the word in- 
 definitely, so long as he does not allow the auditory 
 image to fade into its former obscurity. The im- 
 munity with the particular word is only transient, and 
 when the primary auditory image has disappeared, 
 the stammerer finds the word as difficult as ever.^ 
 
 The stammerer can usually read or speak aloud in 
 unison with other people. This is another fact that 
 has been noted by most writers on the subject of 
 
 1 A peculiar fact should be noted at this point. When the stam- 
 merer has not been understood and is requested to repeat a word, 
 he cannot always do so. The reason for this is twofold. In the first 
 place, the auditory impression from the word is not definite and 
 clear. If the word had been clearly pronounced, it would have been 
 understood by the person listening. If the word is not clearly 
 enunciated, it is evident that the auditory image cannot be greatly 
 strengthened by the aural sensation. The second reason for the 
 stammerer's inability to repeat is that he is seized with mental con- 
 fusion and fear. The effect of these last two factors will be better 
 understood after the perusal of succeeding chapters. 
 
STAMMERING 201 
 
 stammering. Hunt quotes one of his correspondents 
 to the following effect : ^ 
 
 "In private and alone I can read and speak without stutter- 
 ing at all ; and not only so, but in church can join in aU of the 
 responses of the congregation without hesitation, my voice be- 
 ing borne along as it were by theirs ; for if their voices suddenly 
 were silenced, I should become perfectly speechless." 
 
 The explanation for the stammerer's fluency under 
 such conditions is that he is supplied with the auditory 
 impressions of the words by those around him — 
 the case being somewhat analogous to the stammerer's 
 repeating words spoken by another person.^ He de- 
 rives the same assistance from the auditory impres- 
 sions that the musically amnesic patient derives from 
 an accompaniment. 
 
 Wallaschek^ cites the case of the opera singer, 
 Emil Scaria, who was suffering from some incipient 
 cerebral disturbance. The patient was affected by 
 amusia, and found himself unable to recall the notes 
 he had to sing. He therefore requested the manager 
 that some one be allowed to accompany him upon the 
 stage and sing the notes quietly with him, as he could 
 not otherwise remember the music. There seems to 
 
 1 " Stammering and Stuttering," 7th ed., p. 272. 
 
 2 Undoubtedly the stammerer is also assisted by the fact that 
 general auditory impressions tend to facilitate the arousal of the 
 sound-images. (See pp. 347 ff.) 
 
 ' "Die Bedeutung der Aphasie fur die Musik-vorstellung " (Zeit- 
 schrift filr Psychologic, Vol. VI, p. 9). 
 
202 THE PSYCHOLOGY OF STAMMERING 
 
 have been no aphasia; the patient's difficulty lay 
 apparently only with the pitch. Musical amnesia of 
 this kind is quite common even when no cerebral 
 defects are present. It is recognized as the lack of 
 a "musical ear." Often the person cannot keep in 
 tune when he sings by himself, but has no difficulty 
 if some one sings with him or whistles or plays the 
 melody for him. The person with musical amnesia 
 cannot recall the appropriate pitch, but he proceeds 
 without difficulty as soon as the pitch is suppKed by 
 the auditory impressions from without. With the 
 stammerer it is not the pitch, but the vowel-color, that 
 is difficult of recall ; and as soon as this is supplied, 
 the stammerer speaks with perfect fluency. 
 
 Another fact showing the relation between stam- 
 mering and auditory aphasia, and showing the effect 
 of tangibiHty of the auditory image, is that the stam- 
 merer can almost invariably sing without difficulty. 
 In the preceding chapter (pp. 156-160) several in- 
 stances were cited in which aphasic patients could 
 sing quite readily, although they had practically no 
 command of voluntary speech. Thus it is not sur- 
 prising that the stammerer should sing without evinc- 
 ing the impediment. 
 
 The stammerer's abihty to sing could be most 
 easily explained on the supposition that disparate 
 brain-centres preside over the auditory memories 
 for speech and music. It is practically certain that 
 
STAMMERING 203 
 
 the anterior part of the first temporal convolution 
 presides over the musical memory, but it is not en- 
 tirely certain that this centre presides over vocal 
 music. It is possible that it may store up the memory 
 merely of instrumental music or the memory for 
 pitch ; hence it is desirable to find an alternative ex- 
 planation that does not premise the existence of dis- 
 crete auditory centres for speech and vocal music. 
 
 The abiHty of the stammerer (and sometimes of the 
 aphasic patient) to sing is readily explained by the 
 greater tangibiHty of the auditory image in singing. 
 As the long vowel is more tangible than the short 
 vowel, so the musical tone is more tangible than either. 
 The auditory impressions derived from singing the 
 words ''It was the New Jersualem " to their accustomed 
 melody are infinitely more definite and substantial 
 than the auditory impressions derived from speaking 
 the words in a conversational tone at conversational 
 speed. The words, when sung, are more Kkely to re- 
 main in memory in auditory terms. The kinaesthetic 
 images, it should be noted, are practically identical 
 in speech and song. It is the auditory images alone 
 that differ. In song, the auditory nucleus is more 
 substantial. 
 
 The musical memory must subsist largely in auditory 
 terms, for it is almost exclusively a memory of pitch. 
 When a note is sung, it maintains the same absolute 
 pitch through its entire duration, and this pitch is 
 
204 THE PSYCHOLOGY OF STAMMERING 
 
 retained in memory. In speech there is inflection, 
 and the pitch changes even during the enunciation of 
 a single syllable. The pitch, then, is the principal 
 element in song, and vowel-color is purely secondary. 
 As a rule, the vowel-color is sacrificed by the singer, 
 and the auditor is quite unable to tell what words are 
 being sung. This surrender of vowel-color is another 
 reason for the stammerer's ability to sing, for his 
 difficulty Hes with the vowel-color and not with the 
 pitch. Even if the vowel-color were accurately 
 rendered in singing, one could readily explain its 
 greater intensity in auditory memory by the fact that 
 the vowel has a greater duration. In speech, the 
 stammerer has less difficulty with the so-called short 
 vowels that have a relatively long duration ^ than he 
 has with those that are actually accorded a staccato 
 utterance. 
 
 It should be noted that the stammerer cannot sing 
 songs of every kind without difficulty. A "patter" 
 song, by reason of its rapid movement, often causes 
 as much difficulty as speech. The notes are of short 
 duration, and the singing approximates ordinary 
 speech. It is only when the notes are actually 
 
 ^ The short vowels as well as the long vowels can, of course, be 
 prolonged till the breath is exhausted. The designation short and 
 long is rather inapt. The difference is one of color rather than of 
 length, for even in speech the "short" vowels often possess a rela- 
 tively long duration. 
 
STAMMERING 205 
 
 lengthened, and vowel-color gives precedence to pitch, 
 that the stammerer's difficulty in singing vanishes. 
 
 To summarize these arguments : The stammerer's 
 ability to sing is accounted for by the greater sub- 
 jective tangibility of the general auditory impression, 
 and the consequent greater tangibihty of the auditory 
 image. Fluency in singing is further explained by 
 the fact that, in song, pitch is preeminent, while vowel- 
 colors are subordinated. 
 
 These facts present the psychological reasons for 
 the stammerer's abiHty to sing. They do not neces- 
 sarily presuppose that singing is a special faculty 
 subserved by a special brain-centre. But whatever 
 may be the facts in regard to special localization, and 
 whatever the subjective facts concerned, the mere 
 ability of the stammerer to sing supplies a potent 
 argument in support of the thesis that stammering 
 is a form of auditory aphasia. 
 
 It is possible to adduce a physiological reason for 
 the fact that the stammerer sings more readily than 
 he speaks. The inflection of speech demands a far 
 more complicated action of the vocal organs. During 
 the rise and fall of pitch there is an increase or de- 
 crease in the tension of the vocal cords, — this change 
 of tension requiring delicate muscular action. In sing- 
 ing, each single note remains at a definite pitch, and 
 there is no change in the tension of the vocal cords till 
 the next note is reached. This is the explanation that 
 
.206 THE PSYCHOLOGY OF STAMMERING 
 
 is generally advanced for the stammerer's freedom 
 from his defect in singing. There is, however, no 
 occasion to look for physiological explanations, for 
 the various paradoxes of stammering are certainly 
 of psychological origin.^ 
 
 Sufficient has been said of the subjective aspect of 
 stammering to show that it is caused by a failure 
 of the auditory image to rise in consciousness, — 
 in other words, that it is due to auditory amnesia. 
 Subsequently, further evidence will be adduced in 
 support of this thesis; but we shall now consider 
 more directly the points of objective similarity be- 
 tween stammering and aphasia. 
 
 It is generally conceded by investigators that stam- 
 mering is a form of aphasia, but the defect is usually 
 
 ^ There may sometimes exist a physiological disturbance in the 
 brain, but there is no physical defect in the peripheral organs. 
 The absence of physical defect in the organs of speech is easily 
 demonstrated. The stammerer usually enjoys fluent speech for 
 several years before the inception of the impediment; hence his 
 speech-organs cannot be malformed. Furthermore, there are almost 
 invariably certain circumstances under which the stammerer can 
 speak with facility after the development of the impediment. He 
 speaks without stammering in the presence of friends, or perhaps in 
 the presence of strangers; almost invariably he speaks well when 
 alone. He repeats with facility, and speaks well in concert with 
 other people. He does not always stammer on the same words ; and 
 he can repeat — after he has once pronounced it — almost any word 
 that occasions difficulty. Whenever there exists a defect in the 
 peripheral organs, the disturbance in speech manifests itself im- 
 partially under all conditions. 
 
STAMMERING 207 
 
 classified as subcortical motor aphasia, or aphemia. 
 Stammering has rarely been studied as an aphasic 
 disturbance. Indeed, the objective study of stam- 
 mering has in general led to negative results. The 
 symptoms are variable, and there is usually an absence 
 of cerebral lesion; thus the pathologist finds few 
 clews whereon to base his classification. A few cases 
 of stammering have been recorded in which cerebral 
 lesions were present,^ but these lesions have usually 
 been sufficiently extensive to be lacking in significance. 
 Furthermore, in such cases the stammering is a col- 
 lateral disturbance, the major defect being really a form 
 of aphemia. The patient stammers in his attempt to 
 speak, but he stammers on all words impartially ; he 
 uses inappropriate consonants as well as vowels, and 
 his speech is more or less an incomprehensible jargon. 
 These cases cannot be considered as forms of true stam- 
 mering, and no valid deductions can be made from 
 them. 
 
 Stammering resembles aphasia in its mode of origin. 
 Broadly, it may be stated that any cause that induces 
 aphasia can also induce stammering. Most of the 
 causes that occasion stammering can also produce 
 aphasia. (The two causes of stammering that do not 
 produce aphasia are association and imitation. 
 Stammering arising from these causes is not of the 
 
 ^ See Kussmaul, "Storungen der Sprache," 4th ed,, p. 161 and 
 pp. 318 ff. 
 
2o8 THE PSYCHOLOGY OF STAMMERING 
 
 amnesic form ; it will be considered in a later part of 
 the chapter.) The causes of stammering, as given 
 by Ssikorski/ are — emotional shock, traumata, in- 
 fectious diseases, cachexia, convulsions (and imita- 
 tion). These same causes, it will be seen, are among 
 the most proHfic causes of aphasia. 
 
 Transitory stammering frequently occurs, and its 
 causes are similar to those inducing transitory aphasia. 
 Some of these causes cited by Kussmaul ^ are — 
 mental strain from overwork, lack of sleep, the smok- 
 ing of too strong tobacco, intoxication, epileptic fits, 
 indigestion, acute infectious diseases, etc. Temporary 
 aphasia or stammering often occurs during febrile 
 illnesses, disappearing as soon as the fever subsides. 
 Stammering often occurs as the result of anaemia 
 following severe illnesses. When the anaemia is acute, 
 after loss of blood from injuries, for instance, com- 
 plete aphasia often results. 
 
 Stammering sometimes begins as aphasia. 
 
 "H. Schmidt records a case in which a hussar was kicked 
 by a horse on the left side of the forehead, and suffered as a 
 consequence from aphasia, deafness in the left ear, and paralysis 
 of the right arm. Gradually the aphasia disappeared and 
 stammering took its place. After four weeks his full vocabu- 
 lary returned, but the stammering persisted." ^ 
 
 1 "Ueber das Stottern," pp. 232 S. 
 
 2 " Storungen der Sprache," 4th ed., p. 247, 
 
 ' H. Gutzmann, " Sprachheilkunde," 2d ed., p. 381. 
 
STAMMERING 209 
 
 Many such cases are on record in which stammering 
 has begun as aphasia. 
 
 Stammering, like aphasia, often begins with a period 
 of complete mutism, and is often preceded by a period 
 of unconsciousness. Ssikorski ^ observed twenty- 
 seven cases of stammering due to emotional shock, 
 and six of these were introduced by mutism. The 
 duration of the mutism varied from a few hours to 
 six months. Four of these twenty-seven cases began 
 with loss of consciousness. 
 
 Stammering sometimes takes the form of temporary 
 mutism, and the defect is not necessarily stammering 
 speech. (See p. 344; also H. Gutzmann, "Sprach- 
 heilkunde," 2d ed., p. 419.) 
 
 "There are stammerers that never stumble in speech, but 
 that stammer, nevertheless. This sounds paradoxical, but is 
 none the less a fact." ^ 
 
 Stammering varies in severity with the tone of 
 the nervous system ; the same thing is often true of 
 aphasia. Finally, it may be said that there are all 
 degrees of stammering, which range from a sHght hes- 
 itancy in speech to an impairment of utterance that 
 
 1 "Ueber das Stottern," p. 232. 
 
 2H. Gutzmann, "Sprachheilkunde," 2d ed., p. 408. Gutzmann 
 believes these subjects to be breath-stammerers. It seems more 
 probable that the subjects simply experience amnesia, and suppress 
 the physical contortions of the average stammerer. See p. 312 for 
 explanation of common breath-stammering. 
 
210 THE PSYCHOLOGY OF STAMMERING 
 
 imquestionally is aphasia. Speaking of severe forms 
 of stammering, Liebmann says : ^ 
 
 "The worst cases are those in which the speech-disturbance 
 approximates a form of dumbness. I have seen stammerers 
 that were unable to utter a word for weeks, and this, too, in sur- 
 roundings so favorable as the stammerer's own home." 
 
 Speech-disturbances of such severity can scarcely 
 be regarded as stammering : they are aphasia. 
 
 One of the strange features of stammering is that it 
 occurs with far greater frequency in the male than in 
 the female sex. There are four or five male stam- 
 merers to every female stammerer. The chief reason 
 for this disproportion is probably the greater varia- 
 bility of the male sex; the explanation is thus pri- 
 marily biological. In most respects the male shows 
 a greater variability from the norm. Color-blindness 
 occurs in approximately one man in every twenty, 
 but in only one woman in two hundred. The male 
 sex supplies both the geniuses and the idiots of 
 the race. Mentally, females vary little, and any 
 extreme variation from the norm is seldom witnessed. 
 Deaf -mutism is more common among males and so 
 also is aphasia. In reply to an inquiry from the 
 writer, Dr. Wyllie says : 
 
 "My impression is that aphasia is decidedly more common 
 in the male than in the female sex." 
 
 1 "Stottern und Stammeln," p. 46. 
 
STAMMERING 21 1 
 
 Dr. Joseph Collins reports similarly : 
 
 "Aphasia when not due to traumatism is much more com- 
 mon in the males than in the females, the report being that the 
 underlying pathological condition, namely, the various forms of 
 cerebral softening,^ are much more common in males than in 
 females." 
 
 When cases of aphasia due to traumata are included, 
 the proportion of aphasia among males is still greater, 
 for they are more exposed to physical injury. 
 
 Dr. Bastian's monograph, "Aphasia and Other 
 Speech Defects," contains reports of one hundred and 
 fourteen cases of aphasia. Of these cases, seventy- 
 one occur in males and forty-three in females. The 
 cases are, of course, selected to illustrate different 
 principles and not to demonstrate the proportion in 
 which aphasia occurs in the sexes. These numbers 
 may or may not represent the true ratio that exists, 
 but they certainly indicate that aphasia is commoner 
 among males. 
 
 Thus stammering and aphasia resemble each other 
 in the fact that they both occur more frequently in 
 the male sex ; and one of the chief reasons for this we 
 may consider to be the male's greater variabihty. 
 There is perhaps another reason why females stammer 
 less frequently, and this is that their auditory imagery 
 
 ^ "It is known that males are more subject to brain tumor than 
 females." — M. Allen Starr, "Organic and Functional Nervous Dis- 
 eases," 2d ed., p. 574. 
 
212 THE PSYCHOLOGY OF STAMMERING 
 
 is probably more intense. Galton has shown by sta- 
 tistical inquiries that visual imagery is stronger in 
 women than in men. The auditory images are prob- 
 ably clearer also. Certainly girls talk at an earlier 
 age than boys; and conversableness is, in general, 
 greater in the female sex. These facts indicate a more 
 intense verbal imagery. If the auditory imagery is 
 more intense, a minor functional derangement would 
 be less hkely to obKterate or obscure it ; and hence 
 would be less likely to induce stammering. This 
 fact itself would be sufficient to account for the less 
 frequent occurrence of stammering among women. 
 
 Another point of resemblance between stammering 
 and aphasia is furnished by the stammerer's occasional 
 ability to read with fluency. This abihty of the 
 stammerer has been noted by most writers on the 
 subject. Liebmann remarks that : ^ 
 
 "Some stammerers read much more fluently than they 
 speak." 
 
 Another writer says : ^ 
 
 "There are many confirmed stammerers and stutterers who 
 read aloud without impediment." 
 
 The similar ability of some aphasic patients to read 
 with fluency has already been observed (pp. 170-174), 
 and the probable cause for it explained. 
 
 1 "Vorlesungen tiber Sprachstorungen," i. Heft, p. 11. 
 
 ' George Vandenhoff, Homoiopathic Times, New York, May, 1877. 
 
STAMMERING 213 
 
 The interjectional speech of the stammerer is often 
 free from impediment. 
 
 "It is well known that when stammerers are roused by in- 
 dignation, a sense of wrong, etc., they are frequently released 
 from their infirmity, or at least the latter is considerably dimin- 
 ished." 1 
 
 It will be remembered that a similar fluency of 
 speech mider the influence of emotional excitement 
 is often evinced by aphasic patients (pp. 174-175 and 
 p. 124) ; hence we have another point of resemblance 
 between stammering and aphasia. 
 
 We shall consider now a case of aphasia that bears 
 in many points a remarkable resemblance to stam- 
 mering. The speech-disturbance was more severe 
 than that occurring in ordinary stammering, being 
 apparently due to an organic lesion. There was 
 mute-aphasia for several months; but when speech 
 returned, many of the characteristic features of 
 stammering were present. The case is recorded by 
 Bastian : ^ 
 
 "W. D., aged 20, was seen by me in September, 1885, in 
 consultation with Dr. W. A. Phillips. 
 
 "He left England in good health in October, 1884, for a tem- 
 porary residence in Calcutta. After his arrival he soon com- 
 menced some light duties in a merchant's office and continued 
 well till the beginning of the month of May, 1885. During the 
 
 ^ Hunt, "Stammering and Stuttering," 7th ed., p. 269. 
 2 "Aphasia and Other Speech Defects," pp. 73 ff. 
 
214 THE PSYCHOLOGY OF STAMMERING 
 
 first three weeks of that month he suffered from a general erup- 
 tion of boils. On May 25, a very hot day, he went to see a 
 military review, and early in the evening did not feel well. 
 It was thought he had been sHghtly affected by the heat ; the 
 next morning he complained of pain in the back and left side 
 of his head. He had to leave the office about mid-day, not 
 feeling well, and the same thing occurred on the following day. 
 There was no actual sickness and fever, but he remained 
 rather unwell, keeping either to his bed or sofa till Jime 3, when 
 he went for a short sea voyage to Madras and back. 
 
 "He returned to Calcutta on June 21, and while at dinner 
 on that day suddenly became very excited and boisterous, and 
 had a convulsive attack of some kind (no details as to its 
 nature could be ascertained). For about a week after this he 
 was at times odd in manner, sometimes muttering to himself, 
 at others taciturn, with occasional twitchings of the muscles 
 about the face and shoulders. Then one day he suddenly lost 
 his speech, though his intelUgence was unaffected. He under- 
 stood what was spoken or written, and could himself write 
 freely to express his wishes or in reply to questions. 
 
 "Nine weeks after this, having been completely dumb in 
 the interval, he was first brought to me, on September 4, 1885, 
 and he was then in the following condition. He was perfectly 
 intelligent, understood readily all questions that were put to 
 him, and wrote his answers freely and without any hesitation 
 or mistake. He could move his tongue and lips in all direc- 
 tions, but could not utter a sound. The tongue came out 
 straight. During the previous ten days (since his return to 
 this country) he had suffered a good deal from pains in the 
 left parietal and occipital region, and on two occasions had 
 twitchings on the left side of the face. When seen, on tapping 
 the head over the left posterior parietal region, there seemed 
 to be tenderness. There was no lack of symmetry or mobihty 
 
STAMMERING 215 
 
 about the face. The pupils were equal, of medium size, and 
 sensitive to Hght. The optic disks presented nothing distinctly 
 unnatural. There was some paresis of both upper extremities, 
 though this was most marked on the right side; his grip, as 
 measured by the dynamometer, being right 35, and left 47 
 pounds. Some distinct tremors of the right arm were noticed 
 while the instrument was being pressed with the left hand. 
 The knee-jerk on the right side was distinctly exaggerated, 
 both actually and as compared with that of the left side. There 
 was no lack of sensibiHty on either side of the face, trunk, or 
 limbs. Pulse 100, regular; no cardiac bruit. 
 
 "September 9. A small bhster to the nucha having been 
 ordered for the relief of the pains in the head, just after its 
 removal, on September 7, the patient had a convulsive attack. 
 He became rigid, made a guttural sound, had some slight con- 
 vulsions of limbs, and remained unconscious five to ten minutes. 
 Pulse to-day 104, regular. Tongue protruded straight, but 
 covered with white fur on the right side, tremulous. 
 
 ''September 14. Pain in head now gone; no tenderness 
 on left side; bears tapping there wdthout flinching. Right 
 knee-jerk still exaggerated. 
 
 "The patient after this date went to his home in the country 
 for six weeks, where he took six grains of iodide of potassium 
 with three minims of liquor arsenicalis three times a day, and 
 also a draught containing twenty grains of bromide of potas- 
 sium every night. 
 
 "November 26. During the first three weeks after his 
 return the patient had seven fits, but none since that period. 
 The total duration of each fit with subsequent stupor was said 
 to be thirty to ninety minutes. As far as I could learn, the 
 attacks were bilateral, associated with rigidity of limbs, or 
 rigidity and tremors, rather than with actual convulsions, 
 though sometimes these supervened towards the close. No 
 
2i6 THE PSYCHOLOGY OF STAMMERING 
 
 headache now ; this disappeared soon after return. No twitch- 
 ings of face. Pupils equal, rather sluggish to light. No devia- 
 tion of tongue or lack of symmetry about face. No tenderness 
 to percussion any\\'here over head. Knee-jerks now equal, 
 no exaggeration on right. Can walk ten miles without fatigue. 
 Grip much improved, but still weaker on right; right 70, 
 left 93 pounds. Optic disks healthy. Pulse 84, regular. There 
 was no improvement, however, in regard to speech ; I tried in 
 vain to make him utter simple sounds, even after faradisation 
 of throat and assuring him that he would then probably be 
 able to speak. 
 
 "December 2. Writes that yesterday he repeated to him- 
 self the whole of the vowel soimds, and also about twenty 
 monosyllabic words of three letters. 
 
 "December 4. Had a fit on the 2nd whilst at the dentist's, 
 just as he was beginning to inhale laughing gas. I tried to 
 induce him to read to me from a 'school primer.' He sat gazing 
 at the book for several minutes, some tremors and slight twitch- 
 ings of the facial muscles occurring while the efforts were being 
 made. At last he uttered two or three monosyllables in an 
 explosive fashion, at first very indistinctly in a sort of loud 
 whisper, but afterwards others more plainly and at short inter- 
 vals, not in quick succession. Thus, he uttered 'cup,' 'boy,' 
 'hat,' 'hog,' and afterwards read more currently these words: 
 'Let us go to the cow.' 
 
 "December 8. In the interval he has been practising read- 
 ing aloud, mostly when alone. I now made him try again to 
 read to me, and made this note : ' He sits gazing at the book, 
 with his hands between me and the upper part of his face; 
 but I can see his mouth plainly. His lips move, his breathing 
 is irregular, and he seems to be making efforts to pronounce the 
 words he sees ; but no sound comes till the expiration of four 
 and three-quarter minutes, when he said two words in a quick, 
 
STAMMERING 217 
 
 explosive manner, followed at intervals of about a quarter of a 
 minute by two or three more words, and so on through a page 
 of Bell and Sons' " School Primer " composed of short monosyl- 
 labic words. Afterwards he tried to read another page more 
 continuously. This was done rather better, but was accom- 
 panied by much working of facial muscles and apparent effort. 
 His voice was cracked and squeaking in character.' 
 
 "December 15. Previously I had never been able to get 
 him to repeat any words after me, nor to utter any words except 
 what he read in the book as above described ; but this morning 
 he repeated after me the following phrases : ' Good morning ' ; 
 * It is a foggy day ' ; 'If I go on like this, I shall soon go home.' 
 Each of these phrases was uttered after a moment or two of 
 delay, with facial quiverings, and then sudden commencement 
 after the fashion of a stutterer. 
 
 "December 30. He has not spoken to any one at home, but 
 he reads better and with less delay. Has been reading to his 
 sister and his mother. Reads more distinctly to me also. 
 
 "January 15, 1886. Hesitates and makes abortive stutter- 
 ing efforts for three seconds before he can say ' Good morning,' 
 and finally utters it very imperfectly. When set to read from 
 the ' School Primer ' he began after one minute to read in a very- 
 weak, cracky voice. He read a page in an indistinct and very 
 hesitating manner. Writes that he reads to himself daily, and 
 speaks to himself when he is alone. When told to utter his own 
 name, 'William,' he only pronounces it, after several abortive 
 trials, in a very indistinct manner. Has no pain ; sleeps well ; 
 appetite good. Grip right 77, left 77 lbs. 
 
 "February 15. He went on fairly well till February 4, 
 though for some days previously, his sister informed me, he 
 had not 'seemed quite himself — in fact, from the date when 
 his father (thinking he was so much better) gave him, in ac- 
 cordance with his own wishes, some work to do, in the form of 
 
2i8 THE PSYCHOLOGY OF STAMMERING 
 
 accounts and writing, in connection with his country estate. 
 About 7.15 P.M. on February 4, he was found by his sister in 
 a room alone and unconscious in an armchair. He had not 
 been in this room more than about fifteen minutes when he 
 was thus found. He remained unconscious rather over an 
 hour, having from time to time tremors over the whole of 
 the body, the right leg being extended, stiff, and with the toes 
 turned inwards. The right arm was also stiff, but in a flexed 
 condition. His face was dusky. Five days afterwards he 
 had another sHght attack, a 'sort of fainting fit.' When over- 
 tired since, some twitchings have been noticed in the right 
 limbs. He has had no practice in reading or speaking since 
 the fit, and has been more listless in manner. Previously 
 he had been making some progress. He told me in writing 
 that, after commencing the work for his father, he began to 
 have pains in the left side of his head again, though these 
 pains were not worse on the day of the fit, nor had he been 
 over-fatigued on that day. He also said he had-not been sleep- 
 ing well for two or three nights before the fit, having a few days 
 previously left off a bromide draught which he had hitherto 
 been taking every night. 
 
 "I did not see him again till October 9, when he was brought 
 to me by his mother. I learned that from early in June to the 
 middle of August he went away alone to a village in Derby- 
 shire, and lived at an inn there. One of his sisters then went 
 to stay with him, and found him somewhat better. He had 
 been at home for three weeks, and during this time has been 
 communicating with his mother orally, not having occasion to 
 resort to writing once. He has also been reading aloud daily. 
 
 "On examination, I entered the following particulars in my 
 case book : He complained of no pains in his head, and has 
 no local tenderness. Appetite good; sleeps well. Pulse 88, 
 regular ; pupils equal and fairly sensitive ; face quite symmet- 
 
STAMMERING 219 
 
 rical; tongue protruded straight; grip, right 90, left 117. 
 Knee-jerks slight, equal; no ankle clonus on either side. He 
 reads aloud much better than he did; begins without delay, 
 but reads with a weak, rather cracky voice, and with much ap- 
 parent effort and facial contortion a page from Humphry's 
 essay on 'Old Age,' the monosyllables of the school primer 
 being discarded. He speaks, too, in reply to questions, though 
 much more slowly and indistinctly than he should do. His 
 voice is husky; he articulates with much effort and facial 
 contortion, and after an explosive fashion, somewhat like that 
 of a bad stutterer. He was directed to practice reading several 
 times daily, uttering each word as distinctly as possible, and 
 also to resume doing some work for his father in connection 
 with his farm. 
 
 "After this I heard nothing till February 28, 1887, when I 
 received a letter from Dr. Phillips, in which he says in reference 
 to our patient, 'he has now quite recovered his lost faculty, 
 and is occupied in business in London. This result was not 
 in any way sudden, but came about slowly and by continued 
 effort and tuition.' In short, he went on slowly but steadily 
 improving from the time I saw him last till he was sufficiently 
 well to enter his father's office in London." 
 
 It will be noticed that the aphasia in this case 
 bears many remarkable points of resemblance to 
 stammering. In fact, at the time the patient was re- 
 acquiring command of language, the defect seems to 
 have been stammering pure and simple. At a time 
 when the patient had practically no command of 
 spontaneous speech he was able to read and repeat 
 with a fair degree of fluency. Again, the speech- 
 disturbance began with complete dumbness, a symp- 
 
220 THE PSYCHOLOGY OF STAMMERING 
 
 torn that often accompanies the inception of stam- 
 mering. 
 
 The patient's ability to repeat suggests that the 
 cerebral defect was some minor disturbance in the 
 auditory centre. It will be noticed that there was 
 pain in the left parietal and occipital regions. Since 
 the auditory centre Hes conterminous to both these 
 regions, it is quite likely that this centre was affected. 
 A lowered activity of the auditory centre would en- 
 tail difficulty in arousing the auditory images, and 
 hence would induce stammering. It is stated that 
 the patient spoke "with much effort and facial con- 
 tortion, and after an explosive fashion, somewhat hke 
 that of a bad stutterer." 
 
 The patient's dumbness suggests that the cerebral 
 disturbance originally extended into the motor region. 
 Motor disturbances are Hkewise indicated by the 
 facial twitchings and the weakness of the right arm. 
 These conditions had practically disappeared, however, 
 before the mutism vanished. 
 
 The most striking feature of this case was the pa- 
 tient's ability to speak in solitude at a time when he 
 could not speak to other people. In a footnote 
 appended to the report of December 8, Bastian says : 
 
 "About this time, when he told me he had been repeating the 
 vowel sounds to himself, I said he should repeat them to some 
 one else, and he at once wrote : * That is the difficulty. It seems 
 so stupid. I can do it when I am alone, but not to any one.' " 
 
STAMMERING 221 
 
 It is chiefly on account of this feature that the 
 case has been cited. The abiHty to speak well in 
 solitude is one of the characteristics of most cases of 
 stammering. From the nature of the phenomenon 
 it is usually supposed to be dependent upon purely 
 psychological causes. But, as a matter of fact, there 
 are physiological causes that probably underHe the 
 psychological. During intellectual activity there is 
 a great increase in the amount of blood suppHed to 
 the brain. During emotional activity the amount is 
 even greater. When abnormal pathological condi- 
 tions exist in the cerebrum, this increased blood-supply 
 probably interferes directly with consciousness. 
 
 Mosso has made a thorough investigation of the 
 cerebral blood-supply during intellectual activity, 
 em.otion, and sleep. The results are recorded in his 
 monograph, ''La Paura." ^ 
 
 In one experiment he employed a delicately balanced 
 table, on which his subjects were placed. So fine 
 an adjustment could be secured that the table 
 would vacillate with the subject's breathing. Mosso 
 affirms that the head-end of the table would descend 
 if the subject became engaged in intellectual activity^ 
 or if he even endeavored to fix his attention upon an 
 object. If the subject fell asleep, the table had to be 
 
 ^ The excerpts quoted in this work are taken from the German 
 translation, "Die Furcht." There is also an English translation, 
 "Fear." 
 
222 THE PSYCHOLOGY OF STAMMERING 
 
 readjusted on account of the recession of blood from 
 the brain. When the subject awoke, there was so 
 great an afflux of blood to the brain that the head re- 
 mained lowered if the balance were not reestabhshed. 
 
 Mosso showed by means of his plethysmograph that 
 the volume of the arms diminishes during intellectual 
 activity. This shrinkage of the arms is due to the 
 transference of blood from the body to the brain. 
 The shrinkage is, of course, general throughout the 
 body.^ In these experiments it was found that seem- 
 ingly insignificant causes — the entrance of a person 
 into the room, for instance — at once produced a 
 shrinkage of the arms, which the instrument auto- 
 matically recorded by means of tracings. 
 
 Mosso made similar tracings from the pulsations, 
 of the heart. As one would expect, there was an 
 acceleration of the heart correlated with the change in 
 circulation and flow of blood to the brain. The heart 
 beat much more violently during emotional disturb- 
 ances. Further experiments showed that respiration 
 
 ^Thus Leonard Hill in his "Cerebral Circulation" (p. 74) : "An 
 anaemia of the central nervous system excites the vaso-motor centre, 
 and if the splanchnic vessels constrict, the blood pressure rises and 
 more blood is driven through the brain. The same result is pro- 
 duced by asphyxia. We have in the vaso-motor centre a protective 
 mechanism by which blood can be drawn at need from the abdomen 
 and supplied to the brain. At the moment that excitement from 
 the outside world demands cerebral response, the splanchnic area 
 constricts and more blood is driven through the brain." 
 
STAMMERING 223 
 
 was also accelerated by emotion. The greater fre- 
 quency of respiration is probably a secondary phe- 
 nomenon. When the blood flows faster, more rapid 
 breathing is required for its oxygenation. 
 
 In another experiment, performed on three subjects 
 whose brains had been laid bare by lesions of the skull, 
 Mosso recorded the brain-pulse directly by tracings. 
 The investigations showed that the sHghtest intel- 
 lectual activity was accompanied by an increase in 
 the blood-supply to the brain. The brain actually 
 increased in volume, and its pulsations became more 
 vigorous. One day, while experimenting with his 
 female subject, he noticed a sudden strengthening of 
 the brain-pulse and an increase in the volume of the 
 brain for which he could detect no reason. Upon 
 questioning the subject he ascertained that she had 
 caught sight of a skull on the top of a cupboard, and 
 that this had induced a sHght fear in her by reminding 
 her of her illness. 
 
 Mosso made tracings of the brain-pulse during 
 sleep. For long periods the pulse would remain reg- 
 ular but weak. Suddenly there would occur an 
 increased vigor in the pulsations and a dilation of the 
 brain, indicating, beyond doubt, the occurrence of 
 a dream. After a few fluctuations the disturbance 
 would subside, and the brain would shrink again to 
 its normal condition for sleep. During these ex- 
 periments, if the least noise occurred or if a Ught were 
 
224 THE PSYCHOLOGY OF STAMMERING 
 
 brought near the subject, there followed the same 
 increased vigor of the brain-pulse. Calling the sub- 
 ject by name produced more violent disturbances, 
 but these likewise subsided if the subject were not 
 awakened. But if the subject were shaken so that 
 he gradually awoke, there occurred the characteristic 
 expansion of the brain and increased vigor in its 
 pulsations. As the subject fell asleep again, the brain 
 decreased in size and the pulsations again became 
 weaker and more rhythmical. 
 
 With regard to emotion Mosso says : ^ 
 
 "However, the changes in cerebral circulation produced 
 by fear are far greater. The reprimands and threats that I 
 cast at Bertino [the subject], when by moving his head or hands 
 he interfered with the experiment, and the disagreeable things 
 that I occasionally said with intention, invariably produced a 
 vigorous brain-pulse. The pulsations became six or seven 
 times greater than before, the blood-vessels expanded, and the 
 brain swelled and beat with such vigor that my colleagues 
 stared with astonishment at the photogram of the tracings." 
 
 From these facts it should be evident that there is 
 really nothing remarkable in the abihty of a stammerer 
 or a mildly aphasic patient to speak when alone, 
 though he may be unable to speak in the presence of 
 other people. The mere presence of another person, 
 and the greater effort of attention required for con- 
 versation, causes an increased flow of blood to the brain ; 
 
 1 "Die Furcht," p. 73. 
 
STAMMERING 225 
 
 and this, on account of existing abnormal cerebral 
 conditions, induces auditory amnesia. It is a note- 
 worthy fact that auditory images frequently occur 
 during sleep with persons that have no auditory 
 imagery during the waking state. This fact suggests 
 that the greater supply of blood to the brain during 
 the waking state results in a lowering of the activity 
 of the auditory centre. When the imagery is fuga- 
 cious during the waking state, it is probably expunged 
 by the cerebral plethora attendant upon increased 
 intellectual activity. 
 
 Temporary cerebral hyperaemia is probably the 
 cause of stammering in many cases where no organic 
 lesion exists. The cortex of the brain has an extremely 
 rich blood-supply; and any disturbance in the cere- 
 bral vascular system at once reflects itself in conscious- 
 ness. When the vessels become unduly distended, 
 auditory imagery is doubtless inhibited, and stammer- 
 ing results. If a mild organic lesion should exist, the 
 cerebral congestion would aggravate the condition and 
 thus produce disturbances in consciousness. Hence it 
 is possible for amnesia to supervene only when men- 
 tal activity exceeds a certain point. During mental 
 repose — when the person is alone, for instance — no 
 disturbance in speech appears. 
 
 The mental imagery is most likely to be obscured 
 when the subject is affected by intense emotion. 
 Under these conditions cerebral congestion is greatest. 
 
226 THE PSYCHOLOGY OF STAMMERING 
 
 When temporary stammering or aphasia is induced 
 by stage fright or other emotions, it is probably due 
 to the excessive distension of the cerebral vessels. 
 The subjective condition is one of mental cataplexy. 
 When speech-defects are originally induced by emo- 
 tional shock, there is probably a rupture of some 
 of the finer vessels in the cortex.^ Rupture of the 
 larger vessels results in paralysis or death. This rup- 
 ture of the blood-vessels of the brain is known as 
 cerebral apoplexy. 
 
 Disturbances in consciousness are produced by any 
 abnormal condition in the cerebral blood-supply. 
 Cerebral anaemia is just as pernicious as cerebral 
 hyperaemia. In a person suffering from anaemia, 
 aphasia or stammering may occur because the blood- 
 supply to the brain is deficient. A stoppage in one 
 of the cerebral vessels will often cause aphasia by 
 inducing ischaemia, or local anaemia. 
 
 It will be seen from the foregoing pages that stam- 
 mering and aphasia are allied in a great many respects. 
 They are induced by the same causes. They mani- 
 fest many of the same symptoms — the occasional 
 abihty of the subject to read fluently, to speak well 
 when alone, to speak fluently imder the influence of 
 
 1 Ssikorski finds that emotional shock is responsible for stammer- 
 ing in practically three cases out of four. ("Ueber das Stottern," 
 p. 232 and p. 235.) 
 
STAMMERING 227 
 
 sthenic emotions, etc. They are both more common 
 in males than in females. And, finally, there is no 
 strict Hne of demarcation between them. Stammer- 
 ing often begins as mute-aphasia, and it is often suffi- 
 ciently severe at all periods of its manifestation to 
 be regarded as aphasia pure and simple. The specific 
 form of aphasia to which stammering is allied is 
 auditory amnesia, or auditory aphasia.^ It has been 
 demonstrated in numerous ways that the stammerer's 
 difficulty is due primarily to the failure of the audi- 
 tory verbal image, his difficulty manifesting itself 
 on that part of the word that cannot be readily pro- 
 duced kinaesthetically — i.e. on the vowel. When 
 the acoustic image is subtile and indefinite, he has 
 greater difficulty in recalling it. Hence, he more 
 frequently stammers on, or mispronounces, the short 
 vowels. When the auditory image is definite and 
 tangible, the stammerer can more readily recall it. 
 Hence he stammers httle on the long vowels and rarely 
 hesitates in singing. When the primary auditory im- 
 age is clear, his difficulty vanishes. Therefore he 
 repeats readily, and speaks fluently in unison with 
 other persons. 
 
 Thus the arguments are practically conclusive in 
 
 support of the thesis that stammering is a form of 
 
 auditory amnesia. But since stammering has been 
 
 regarded by most investigators as some obscure and 
 
 * Amnesia is the subjective condition ; aphasia rather the objective. 
 
228 THE PSYCHOLOGY OF STAMMERING 
 
 undiagnosable form of subcortical motor aphasia, or 
 aphemia, it might be well to consider the arguments 
 against this latter theory. 
 
 If stammering were due to an organic lesion in the 
 neural mechanism actuating speech, it would often 
 be accompanied by some degree of hemiplegia. How- 
 ever, hemiplegia is almost invariably absent in stam- 
 merers. Even when the disorder is suddenly induced 
 by emotional shock, there is usually no S3niiptom of 
 paralysis. The writer has seen only one case of 
 stammering (among approximately two hundred) in 
 which paresis existed. There was in this instance 
 a mild paretic condition of the right arm. But in this 
 case the speech-disorder could scarcely be classified 
 as stammering. The disturbance was of a motor 
 nature. There seemed to be difficulty in articulating 
 the consonants; but when these were pronounced, 
 the vowels were readily subjoined. Speech was 
 lethargic and heavy, and it had few of the usual 
 characteristics of stammering. 
 
 If stammering were a form of aphemia, it would be 
 impossible to effect even a temporary cure by elocu- 
 tionary methods, for elocutionary exercises can have 
 practically no effect upon those parts of the brain 
 that do not subserve consciousness. Yet more or 
 less transitory ^'cures'' are effected by elocutionary 
 training in a few instances. The explanation for 
 the improvement in speech is probably that the 
 
STAMMERING 229 
 
 vocal exercises effect a transitory intensification of the 
 auditory imagery. 
 
 The supposition that stammering is a form of aphe- 
 mia does not explain the stammerer's greater difiiculty 
 with the short vowels. It does not explain his ability 
 to repeat and his abihty to sing. To generalize, the 
 theory does not explain the stammerer's abihty to 
 speak when he has a clear auditory image of the word 
 he wishes to utter. One might explain this abihty 
 on the supposition that the stronger impulsion given to 
 the efferent current by a clear auditory image enables 
 it to overcome an abnormal resistance in the motor 
 cells or fibres. But even when this supposition is 
 made, the cause of the speech-defect — when the 
 subjective aspect is considered — still remains the 
 failure (or in this case the weakness) of the auditory 
 image. But the assumption that there exists an 
 undue sluggishness in the motor mechanism does not 
 explam the fact that the stammerer frequently pro- 
 duces a wrong vowel after his struggles to articulate 
 a word, and the fact that some stammerers experience 
 difficulty only with particular vowels. The existence 
 of a motor defect is disproved by the fact that the 
 stammerer has difficulty neither in articulation nor in 
 phonation. When consonants are followed by long 
 vowels he usually produces them with ease. He 
 never stammers on the consonants at the end of a word. 
 He has no difficulty in phonation, for he often vocaHzes 
 
230 THE PSYCHOLOGY OF STAMMERING 
 
 continuously on the continuous sonant consonants. 
 If the difficulty lies neither in articulation nor phona- 
 tion, it can scarcely be due to a motor disturbance. 
 
 Neither can there be a defect in the kinaesthetic 
 verbal memory-centre, for if such were the case, 
 the stammerer would have as much difficulty in sing- 
 ing as in speaking. He would stammer more on the 
 consonants than on the vowels, and would not articu- 
 late the consonants freely — as he does in stuttering 
 and many forms of stammering. In many cases the 
 stammerer would be hemiplegic. If there were a de- 
 fect in the kinaesthetic memory, the stammerer would 
 not be readily affected by shght differences in the 
 tangibility of the auditory image, and would not repeat 
 with his characteristic ease. — One might suppose, to 
 explain the effect of tangibihty in the auditory image, 
 that the stronger sound-image arouses the associated 
 kinaesthetic image more promptly. If the kinaesthetic 
 image is the last provocative of speech, this associa- 
 tional process must of course occur invariably in the 
 audito-moteur, — though the awakened kinaesthetic 
 image does not come to the foreground of conscious- 
 ness, since the speaker attends to the auditory and 
 not to the motor image of the vowel. If the kin- 
 aesthetic image of the vowel-movements were suffi- 
 ciently strong to appear independently in conscious- 
 ness, the auditory image would be dispensable. In 
 a sense, then, one could attribute the stammerer's 
 
STAMMERING 231 
 
 difficulty to a deficiency in his kinaesthetic imagery, 
 but this is only saying that the stammerer is an audito- 
 moteur rather than an articulo-moteur. If he were 
 an articulo-moteur, he would not be a stammerer. 
 
 There are cogent arguments against the existence 
 of a lesion in the fibres uniting the auditory and kin- 
 aesthetic verbal centres. A defect in either set of 
 fibres would not explain the stammerer's greater 
 difficulty with the shorter vowels. It would not ex- 
 plain his abihty to repeat, to sing, and to read aloud 
 in unison with others. We might assume, again, 
 that the stronger auditory image overcomes an ab- 
 normal inertia, but we should still have to explain 
 the fact that the stammerer often produces the wrong 
 vowel and the fact that difficulty occurs in some cases 
 only with vowels of a particular coloration. The 
 assumption, moreover, would still leave the subjective 
 defect a failure (or weakness) of the auditory image. 
 It seems clear that this theory of the failure of the 
 auditory image is the only one that satisfactorily ex- 
 plains all the phenomena involved. 
 
 It is not at all difficult to explain the fact that the 
 auditory faculties are particularly vulnerable, — and 
 more Hable to derangement than the motor faculties, 
 for instance. Hearing is one of the distance-receptors, 
 and is a more recent acquisition in the evolution of 
 the human race. It is one of the later terms in evolu- 
 tion, and hence is one of the earlier terms in dis- 
 
.232 THE PSYCHOLOGY OF STAMMERING 
 
 solution. The motor faculty is phylogenetically the 
 oldest, for the converting of a sensory stimulus into 
 a motor response is one of the primordial functions 
 of protoplasm. This motor fimction of the nervous 
 organism is therefore the least likely to be undermined. 
 The auditory function, on the other hand, is relatively 
 vulnerable ; and it is Hable to derangement by even 
 a minor cerebral disturbance. 
 
 Taking the faculty of speech, we find that vowel- 
 color is phylogenetically and ontogenetically later in 
 development than pitch. Vowel-coloration is, in 
 fact, the last term in evolution, and is hence the first 
 term in dissolution. Pitch belongs to natural or 
 emotional speech; vowel-color belongs to artificial 
 language. Vowels express nothing in themselves by 
 their coloration. Their use in language (together with 
 consonants) is almost as factitious as the use of writ- 
 ing. Speech-sounds are merely so many symbols 
 arbitrarily associated with different objects and 
 actions in order that the latter may be designated. 
 Natural language, the language of pitch, is found in 
 most of the lower animals, and by means of it they 
 give expression to their emotions. Apes chatter to 
 each other or to an ape-audience ; but the sounds that 
 they emit are merely pitch-sounds that express their 
 feehngs. In the language of the human child we find 
 that pitch precedes vowel-color. Musical recognition 
 and expression precede the recognition and expression 
 
STAMMERING 233 
 
 of language. Long before the child has gained 
 command of language he is able to express anger, 
 fear, and affection by means of sounds of different 
 pitch. These sounds may have the same vowel- 
 color throughout : the child gives utterance to a series 
 of (fa's, fox instance, but he expresses his feehng per- 
 fectly by means of the inflection. Pitch is thus older 
 than vowel-color in the development of both the race 
 and the individual. For this reason, appreciation of 
 pitch is less readily lost, and the aphasic patient may 
 understand and give utterance to pitch-sounds when 
 language is no longer expressed or understood. But 
 since vowel-coloration is the last term in develop- 
 ment, the memory and appreciation of vowel-quaHties 
 is usually the first to be impaired, and these faculties 
 are disturbed by conditions that do not affect the 
 memory or appreciation for pitch. The fact that 
 vowel-coloration is the first term in the dissolution 
 of speech accounts for the position that stammering 
 holds as the commonest of all speech defects.^ 
 
 Minor disturbances in faculties other than the 
 auditory and motor undoubtedly occur ; but they do 
 not afifect speech, and hence give rise to no marked 
 objective symptoms. 
 
 ^ Amnesia of pitch would not induce stammering even if this form 
 of amnesia were to occur. But the stammerer's difl&culty does not 
 lie with pitch, for he produces pitch when stammering on the con- 
 tinuous sonant consonants — and the pitch, moreover, is usually 
 accurate. 
 
234 THE PSYCHOLOGY OF STAMMERING 
 
 That stammering is an auditory disturbance is 
 borne out by the fact that it does not occur in persons 
 not dependent upon auditory cues. Stammering 
 seems to be entirely absent among the congenitally 
 deaf that have been taught to speak. Concerning 
 this matter, Hermann Gutzmann writes as follows : ^ 
 
 "It is well known that the congenitally deaf never stammer 
 — and in Germany, at least, they are all taught by the oral 
 method and gain a thorough mastery of speech. The reason 
 for this is manifest. In the first place, they learn speech under 
 the constant supervision of an instructor; and in the second 
 place, they learn to associate ideas with words only as they 
 slowly and progressively acquire mastery of the articulative 
 organs. The objection — which has been made — that there 
 are stammering children in institutions for deaf-mutes does 
 not affect the validity of the statement ; for it is certain that 
 these children are only hard of hearing or that they have be- 
 come deaf only after normal speech had been acquired. For 
 my part, I have never met a stammering child in a school for 
 deaf-mutes ; but I do not disavow the possibility of their exist- 
 ence, which is reasonable enough from the above point of view.'* 
 
 Dr. Gallaudet, President of the Columbia Institu- 
 tion for the Deaf and Dumb (Washington, D.C.), says, 
 in a communication to the writer : 
 
 "I have never known a congenitally deaf person who stam- 
 mered or stuttered." 
 
 Concerning the number of orally taught deaf persons 
 he has met. Dr. Gallaudet writes : 
 
 ^ "Sprachheilkunde," 2d ed., p. 376. 
 
STAMMERING 235 
 
 "I have been engaged in teaching the deaf for more than 
 fifty years, and have visited many schools in this country and 
 Europe. I must have met many thousands of this class of 
 persons." 
 
 Gutzmann's explanation for the deaf person's im- 
 munity — that he is more carefully taught and that 
 his speech and conceptual faculties develop concur- 
 rently — is certainly inadequate. The deaf person 
 is subject to all the usual inducing causes of stam- 
 mering, infectious diseases, shock, etc., and if there 
 were no more fundamental reason for his immunity, 
 he would certainly fall victim to the disorder as do 
 persons of normal hearing. The reason for his in- 
 vulnerability is undoubtedly found in his lack of 
 auditory imagery, and the consequent failure of a dis- 
 turbance in the auditory brain-centre to affect his 
 mental and oral speech. With most congenitally 
 deaf persons there is probably atrophy in the temporal 
 region, but this degeneration has, of course, no effect 
 upon consciousness. 
 
 In some cases of stammering the impairment of the 
 auditory imagery appears to be sufficiently severe to 
 entail a mild degree of word-deafness. Denhardt 
 says in reference to the stammerer's interpretation of 
 language : ^ 
 
 "With extraordinary frequency one observes in the stam- 
 merer a certain tardiness of perception, which is in no way due 
 
 ^ "Das Stottern eine Psychose," p. 188. 
 
236 THE PSYCHOLOGY OF STAMMERING 
 
 to lack of intelligence, but rather to lack of practice in, and in- 
 sufficient habituation to, the exchange of thought through the 
 medium of spoken language. It is as though the verbally 
 expressed thought required with the stammerer a longer time 
 than it does with the normally speaking person to reach the 
 seat of intelligence through the ear and to receive its interpreta- 
 tion." 
 
 The reader will recognize at once that Denhardt is 
 really describing a mild condition of word-deafness. 
 The occurence of a degree of word-deafness in stam- 
 merers is not surprising. The condition is one that 
 might well be expected to occur under circumstances 
 that oblige the stammerer to give oral expression to his 
 thoughts as well as to listen to the words of other 
 people. The necessity for speaking imposes upon him 
 a mental strain, which, with the attendant fear,' is 
 sufficient to stifle the auditory imagery. There is 
 probably a condition of cerebral hyperaemia increasing 
 the inertia of the auditory cells; and this inertia 
 renders the cells almost as slow to receive auditory 
 impressions as they are to yield mental images. 
 
 But this word-deafness is not present solely during 
 mental excitement. The writer has remarked its 
 presence in stammerers during moments of complete 
 tranquillity. It usually takes the form of a tendency 
 to misinterpret vowels. To cite specific instances : 
 Camp was misinterpreted as Kemp; Woolley as Wyllie 
 (short y OY i) ] man as men; pen as pin; sighing as 
 sewing^ etc. In actual speech, the stammerer's vowels 
 
STAMMERING 237 
 
 are often far from pure even when the impediment is 
 not in evidence. He is frequently misunderstood, or, 
 rather, un-understood ; and is consequently called upon 
 to repeat — much to his embarrassment. As regards 
 misinterpretation of vowels, it is certain that this 
 occurs with some degree of frequency in persons of 
 normal speech ; hence it is impossible to say from 
 casual observation whether or not the phenomenon oc- 
 curs more frequently among stammerers. The matter 
 is one for investigation in the psychological laboratory. 
 Apparently the average non-stammerer is not re- 
 markably apt at interpreting sounds. When Wyllie 
 made his interesting experiments in the perception of 
 an apple through different senses, he tested a number 
 of persons by paring an apple with a table knife, hold- 
 ing it near the ear of the subject. 
 
 "Sixteen persons in all, mostly adults, were tried in this 
 fashion, and of the whole number only three answered correctly, 
 'You are paring an apple.' The others thought we were paring 
 wood, clipping paper with scissors, rubbing salt, rubbing two 
 surfaces of cloth together, etc." ^ 
 
 In view of these remarkable results it behooves one 
 to be conservative in drawing conclusions concerning 
 the relative ability of the stammerer to interpret sounds 
 and spoken language. The writer is, however, of the 
 opinion that a large proportion of stammerers manifest 
 
 ^Wyllie, "Disorders of Speech," p. 228. 
 
.238 THE PSYCHOLOGY OF STAMMERING 
 
 some degree of word-deafness under such conditions as 
 induce severe stammering ; i.e. under conditions that 
 subvert the auditory imagery. 
 
 The writer has endeavored to ascertain the nature of 
 the mental imagery possessed by the average stam- 
 merer. The method employed was the circulation of a 
 questionnaire. A general description of mental im- 
 agery, similar to that given in Chapter I, accompanied 
 the question-forms, for most of the subjects had, un- 
 fortunately, little knowledge of psychology. The 
 questions employed were as follows : ^ 
 
 1 The writer would appreciate replies to this questionnaire from 
 any of his readers that happen to be stammerers and have some 
 knowledge of psychology. A general description of the mental 
 imagery of each type would, of course, answer the purpose. In- 
 formation is desired especially in regard to the auditory imagery 
 and the verbal imagery. The motor imagery — especially of articu- 
 lative movements — is also important. If the reader should confine 
 himself to the questions here given, it might be well to observe 
 the following directions, which prefaced the questionnaire in its 
 original form : 
 
 "Read the questionnaire through before beginning to reply. Do 
 not trouble to repeat the questions ; refer to them simply by number. 
 Make your answers as complete as possible, avoiding where prac- 
 ticable such replies as Yes and No. If unable to answer a question, 
 state the fact frankly. Usually it will answer itself at some moment 
 when you are watching your thoughts. 
 
 "Be careful not to describe the image of a sensation that you 
 have just previously experienced. Such images, are, as a rule, 
 exceptionally vivid. Confine your description to images of sensa- 
 tions that have not occurred within the preceding five or ten min- 
 
STAMMERING 239 
 
 QUESTIONNAIRE! 
 
 1. Think of some person who is well known to you, but whom 
 you have not seen for some little time. Do you clearly see the 
 features ; the outline of the figure ; the color of the clothes ? 
 Do you seem to see the person through a mist, or in a very 
 poor light ? 
 
 2. Have you a distinct memory for the scenes that you ob- 
 serve in daily life ? Do the objects appear to you in a clear 
 light, and with good definition? Are the colors natural? 
 
 3. Can you picture scenes described in a novel ? 
 
 4. How do your visual images differ from objects as you 
 actually see them ? 
 
 5. Imagine yourself brushing your hair. Do you distinctly 
 feel the arm-movements that you would employ ? 
 
 6. Can you in memory revive the hand-movements involved 
 in writing your signature? Do you either hear or feel the 
 scratching of the pen upon the paper ? Does the performance 
 seem awkward as you imagine yourself writing with the left 
 hand? 
 
 7. Can you imagine the (touch) sensations that you would 
 get from handling a piece of sandpaper ; a wet cake of soap ; 
 a crisp, dead leaf ? 
 
 8. Can you mentally distinguish the feeling of a handful of 
 sand from that of a handful of sawdust? Can you, by your 
 memory for feeling, mentally distinguish silk from velvet; a 
 light pin-prick from a deep pin-prick ; a snowball from a ball of 
 dough ? 
 
 utes. It is advisable to make these tests under conditions of quiet, 
 in order to facilitate concentration of attention. Closing the eyes 
 will frequently intensify the mental images." 
 
 1 Some of these questions are taken or adapted from standard 
 questionnaires. 
 
240 THE PSYCHOLOGY OF STAMMERING 
 
 9. Can you imagine the feelings of different objects as you 
 think of yourself groping in the dark ? 
 
 10. Can you recall the odor of violets ; of cheese ; of tobacco- 
 smoke ; of frying bacon ? 
 
 11. Can you recall the taste of a lemon; of salt; of sugar; 
 of some bitter substance, such as quinine ? 
 
 12. Can you imagine the scalding sensation from coffee that 
 is too hot to drink ? The coldness of ice-cream ? 
 
 13. Do you get an image of pain as you imagine yourself 
 slashing your wrist with a knife ? 
 
 14. Hold your hands as though about to clap them together. 
 Can you distinctly hear the sound that is about to occur ? Now 
 strike the hands together and compare the sound with your 
 auditory image. Was the latter clear and accurate ? 
 
 15. Hold your fingers ready to snap them. Can you clearly 
 think of the sound in this case ? Verify the image. 
 
 16. Go to the window and hold your hand as though about to 
 tap the pane with the knuckles. Can you distinctly imagine 
 the sound that is about to occur ? Verify by tapping the pane. 
 Was your image vivid and accurate, or were you totally unable 
 to think of the sound ? 
 
 17. Can you hear in memory the beat of rain against the 
 window-panes ; the crack of a whip ; a church bell ; the hum 
 of bees ; a train-whistle ; the chirping of sparrows ? 
 
 18. Can you caU to mind instrumental music so that it gives 
 you pleasure ? 
 
 19. Can you, at will, imagine tunes on different instruments, 
 — the piano, flute, cornet, etc, ? 
 
 20. Do you play any instrument by ear ? 
 
 21. Do you sing to entertain friends ? 
 
 22. Do you frequently have tunes running through your 
 head ? If so, do you hear such tunes on an instrument, or do 
 you mentally sing them in words ? 
 
STAMMERING 241 
 
 23 . Can you mentally whistle a melody ? 
 
 24. Can you clearly recall the voices of your friends ? Do 
 you recall voices or faces more readily ? 
 
 '25. As you read a letter from a friend, are the words in your 
 own voice, or unmistakably in the voice of the writer ? 
 
 26. Do you imagine a different voice for each character in a 
 novel ? 
 
 27. When thinking in words, do you hear them within your 
 head, or do you seem to be mentally articulating them; i.e. 
 speaking them with lips, tongue, etc. ? 
 
 28. Does your thinking voice resemble your speaking voice 
 in quality, volume, pitch, inflection, etc. ? or does the voice 
 appear to be nobody's in particular — a sort of standard think- 
 ing voice ? 
 
 29. Does the memory of your whispering voice seem to 
 differ from that of your speaking voice ? (Make the compari- 
 son on the normal inward breath, and not while exhaling.) 
 
 30. Open the mouth, and without moving the lips read 
 silently the following words : wobble, bubble, toddle, woman, 
 mimicry. Do these words appear thick and unnatural, as 
 though you were attempting to speak with the lips apart ? 
 
 31. Do you ever move the lips when reading silently ? 
 
 32. Do you, when speaking, have visual images ("printed" 
 or "written") of the words that you utter? 
 
 S3. Can you hear in imagination the barking of a dog? 
 The crowing of a cock? Do you clearly hear the sounds, or 
 does it appear that you are mentally saying them ? Are your 
 images unmistakable animal cries, or merely the conventional 
 "bow-wow" and "cock-a-doodle-doo"? 
 
 34. Imagine yourself tapping a tea-cup with a spoon. Can 
 you mentally hear the clinking sound ? Do you feel yourself 
 manipulating the spoon ? Are visual images present ? 
 
 35. Imagine yourself firing a revolver. Do you feel the 
 
242 THE PSYCHOLOGY OF STAMMERING 
 
 weapon in your hand ? Do you feel yourself pulling the trigger ? 
 Is the report clear and sharp ? Do you mentally stand off and 
 see yourself performing the act? Are you able to do this if 
 you wish ? 
 
 36. When the word violin is suggested, do you think first of 
 the appearance of the instrument or of the sounds made when 
 it is played ? 
 
 37. Think of a train. What mental images are present in 
 the thought ? 
 
 3,S. Give your mental image-types in order of decreasing 
 intensity. 
 
 39. Give any supplementary information that may occur to 
 you in reference to your mental imagery. 
 
 Further questions were given concerning the rela- 
 tive difficulty experienced with long and short vowels, 
 and concerning the stammerer's ability to repeat 
 words spoken by others, to speak in unison with 
 others, to sing, etc. In every case the replies bore out 
 the statements already made in this chapter concern- 
 ing the various paradoxes of stammering. 
 
 Several of the subjects clearly indicated by their 
 replies that they had experienced the amnesia during 
 speech — and none of them, by the way, knew any- 
 thing of the theory the writer is advocating in the 
 present monograph. Two of the correspondents 
 stated that they found the mind to be absolutely 
 blank when they stammered. Had they been versed 
 in psychology, they probably would have said that 
 there was an occurrence of auditory amnesia. Most 
 
STAMMERING 243 
 
 of the subjects stated, in reply to a question, that 
 they would intuitively recognize an unfamiliar word as 
 difficult — the name of a person or a town, for instance. 
 This means either that the auditory image disappears 
 during silent thought^ or that the kinaesthetic image of 
 the word is distorted. (The subject of distorted 
 imagery will be discussed later.) With an absolutely 
 strange word, it is more Hkely that the former con- 
 dition prevails. 
 
 The writer gives here a set of his answers to the ques- 
 tions. He finds it necessary to give his own answers 
 rather than those of his correspondents because, im- 
 fortunately, none of these subjects were trained in in- 
 trospection. 
 
 (i) The features, the outline, etc., are dim. The figure 
 appears as through a dark mist or as though seen on the outer 
 edge of the field of vision. The figure, however, is at the centre 
 of the mental visual field. There is practically no color in the 
 figure till I actually look for it. Then the colors are faintly 
 discernible. I can just distinguish them as I would distinguish 
 real colors in relative darkness. 
 
 1 The average stammerer will probably find upon introspection 
 that auditory amnesia not infrequently occurs during silent thought. 
 The auditory nucleus then drops from the word, leaving a kin- 
 aesthetic outline. This imperfect image is quite sufl&cient for 
 silent thought ; for it is the fimction of the word — its associations, 
 and not its intrinsic content — that is significant. But the image is 
 not adequate for oral speech. The speaker must know not 
 merely what the word means ; he must know, f vuther, how the word 
 sounds. 
 
244 THE PSYCHOLOGY OF STAMMERING 
 
 (2) My visual images of scenes are pictorial abortions. 
 The light is poor to the last degree, and the mental picture is 
 lacking in detail. The picture appears in Hght and shade 
 rather than color. I can introduce color only by an effort of 
 attention. Even then the color is not usually distinct. 
 
 (3) Scenes that I imagine are about as clear, or dim, in my 
 mind as scenes that I remember. 
 
 (4) The imagery described in answers (i) and (2) is quite 
 typical. My visual images are commonly lacking in color and 
 detaU, and the illumination is defective. In this respect 
 the images are like pictures taken from a bad negative : they 
 show the contour and body of an object, but none of the finer 
 points. I find that the detail is brought out at a particular 
 point of the image only by direct attention to it. On the whole, 
 my visual images are so vestigial that I almost wonder how I 
 think. Yet, when my visual images become detailed and 
 colored, as sometimes happens during extreme fatigue, I find 
 that the clear optical images are distracting. They seem to 
 divert the attention from the relations existing between them, 
 and thus they impede abstract thought. 
 
 (5) The arm-movements are almost as distinct as though I 
 actually made them. Mentally, I can execute almost any mus- 
 cular movement, and can "feel" the movement with great 
 clearness. 
 
 (6) I can feel the hand-movements with great distinctness. 
 I feel the movement of the pen over the paper, and feel the vari- 
 ations in pressure. The pen, however, moves silently. The 
 performance is just as awkward when I write mentally with the 
 left hand as when I do so in fact. 
 
 (7) All of these touch-sensations are very clear. My tactile 
 images are scarcely less vivid than my kinaesthetic images. 
 I can feel the sharp grains of sand as I handle the sand-paper. 
 I can feel the wet and slimy cake of soap, and by a movement 
 
STAMMERING 245 
 
 of the thumb and fingers can turn it over and over in my hand. 
 I feel the sharp edges of the leaf as I crumble it in my hand. 
 
 (8) I can make all of these distinctions quite readily. In 
 the case of the pin, however, I distinguish a mere touch from a 
 light pin-prick. I cannot get a very distinct image of pain as 
 I imagine the heavier pressure of the pin. 
 
 (9) These images occur with great vividness. 
 
 (10) The olfactory images do not appear to be very clear, 
 and I meet with little success as I endeavor to think of the odors 
 in the order mentioned, though for a moment I get a faint 
 mental image of the odor of the bacon. Olfactory images are, 
 however, sometimes quite vivid in my consciousness, and a 
 distinct image will occasionally rise without any overt associa- 
 tional connection, 
 
 (11) These gustatory images are not very clear, though I 
 get a fairly good image of the taste of the lemon. Taste-images 
 often seem to me to be quite intense, but I find upon analysis 
 that this is due in large part to the prominence of the tactual 
 element ; the actual gustative element is often relatively weak. 
 
 (12) The thermal images are fairly clear, though by no 
 means so strong as the normal touch-images. 
 
 (13) There is not a clear, localized image of pain, though I 
 distinctly feel the touch of the knife. The flesh seems to be 
 analgesic but not anaesthetic. The thought of cutting my wrist 
 is accompanied by a distinctly disagreeable element that seems 
 to take the form of a general chiU. 
 
 (14) I can get absolutely no image of sound. I can mentally 
 feel and see the movements that my hands would make, and 
 can mentally feel the contact of the hands ; but I am deaf to 
 the sound that would occur. 
 
 (15) Utter silence. 
 
 (16) Ditto. 
 
 (17) I find it impossible to think of these things in tenns of 
 
246 THE PSYCHOLOGY OF STAMMERING 
 
 sound. The thoughts are visually represented. In the case 
 of the whip and the bell there are also motor images : I mentally 
 crack the whip and pull at the bell-rope. No soimd, however, 
 supervenes. 
 
 (18) Am quite unable to recall instrumental music. 
 
 (19) Impossible. 
 
 (20) No. 
 
 (21) No. 
 
 (22) I can occasionally recall a tune; but this is often in- 
 accurate. I must always associate the tune with words. The 
 words I find to be auditory-motor. 
 
 (23) No. 
 
 (24) I find it practically impossible to recall voices. Some- 
 times I can associate the timbre of a person's voice with some 
 simple expression, such as "Good morning," or with a single 
 word like "Yes" or "No." In this case I find that / am saying 
 the word with the other person's voice ; i.e. I feel the word as 
 I hear it. 
 
 I of course recall visual images of faces more readily than 
 this. 
 
 (25) Always in my own thinking voice. 
 
 (26) The characters all have the same voice; that is, my 
 own thinking voice. 
 
 (27) I mentally feel the diflferent speech-movements and 
 mentally hear the vowels. Occasionally I have an acoustic 
 image of a sonant consonant hke m or n, but these images are 
 not very conspicuous. 
 
 (28) The acoustic element in my mental voice varies greatly. 
 Occasionally it possesses unmistakable timbre, and then the 
 timbre, of course, resembles that of my speaking voice. On 
 such occasions the volume, pitch, and inflection can also be 
 detected ; but these elements are felt as well as heard. When 
 the acoustic element in the voice happens to be weak, all timbre 
 
STAMMERING 247 
 
 virtually disappears. The voice then loses its character and 
 becomes a sort of standard thinking voice ; i.e. it is predomi- 
 nantly kinaesthetic. But even under these conditions it possesses 
 pitch and inflection, these elements being represented to some 
 extent in terms of feeling. 
 
 (29) I find that the acoustic intensity of my voice is prac- 
 tically the same whether I mentally whisper, speak aloud, or 
 shout. The only difference detected is in the" effort" put 
 forth. 
 
 (30) The mental words appear thick and unnatural. 
 
 (31) Yes, occasionally; and especially if the lips should 
 momentarily be apart. 
 
 (32) These images do not usually appear; but by an act 
 of conscious attention I can arouse visual images of words 
 fairly readily. But though these images appear promptly, they 
 are not at all distinct. 
 
 {^T,) I am mentally saying the words. The words are audi- 
 tory-motor. 
 
 (34) I can picture the scene and can mentally feel myself 
 manipulating the spoon. I can feel and see myself striking 
 the teacup, but I do not get an image of the sound. 
 
 (35) I see my arm before me and see the weapon in my hand. 
 I distinctly feel the revolver and feel myself pulling the trigger. 
 I can see the smoke and can feel the "kick," but I do not hear 
 the sound. Now I can mentally stand off and see myself go 
 through the performance. The image is about as clear — or 
 dim — as any other visual image, but I have no trouble 
 in redintegrating it. The revolver is again of the noiseless 
 type. 
 
 (36) I think of the appearance of the instrument. I cannot 
 think of its sound, 
 
 (37) I am standing about a hundred feet from the railway, 
 and I see the train go rapidly and silently past me. I can see 
 
248 THE PSYCHOLOGY OF STAMMERING 
 
 the contour and body of the train, but I see practically none of 
 the details unless I look for them individually. 
 
 (38) Motor and Tactile. 
 Visual. 
 
 Thermal and Algesic. 
 Gustatory. 
 Olfactory. 
 Auditory. 
 
 (39) Although my visual images are vestigial, I find that 
 they predominate in my thinking. Much of my abstract thought 
 proceeds in visual imagery. These visual images are often 
 diagrammatic, and various parts of the image or various images 
 then move in such a manner as to express relations. Often 
 the relation is expressed by an eye- or hand-movement in motor 
 terms. Very little abstract thought seems to occur in verbal 
 imagery. I can usually think more freely and more rapidly 
 if I do not stop to express my thoughts in words. 
 
 I not infrequently experience strong auditory images during 
 dreams, and I have found these images to occur during fever. 
 But during the waking state no sound-image enter my con- 
 sciousness except the soimd-images associated with my verbal 
 thought. 
 
 It is somewhat difficult to say whether the lack of 
 auditory imagery indicated by these answers is char- 
 acteristic of the average stammerer. The writer is 
 inclined to believe that such is the case. Very few 
 stammerers possess a ''musical ear." Charles Lamb 
 probably spoke for the majority of stammerers when 
 he said, " Sentimentally, I am disposed to harmony; 
 but organically, I am incapable of a tune." Among 
 approximately two hundred stammerers the writer 
 
STAMMERING 249 
 
 has known only two that were able to sing without 
 disgracing themselves.^ 
 
 Several writers have remarked the defective ear of 
 the stammerer. Klencke says : ^ 
 
 "I put notes by the side of the vowels to indicate the key 
 in which they are to be produced. By so doing, the patient 
 acquires the use of his voice in its full compass and cultivates 
 his ear for the tone, in distinguishing which nearly every stutterer 
 [stammerer] is defective." 
 
 And thus Albert Gutzmann:' 
 
 "If a child cannot distinguish a high from a low tone by the 
 ear (I have often found that with adult stuttering persons) he 
 may put his hand on the larynx of the teacher or of another child 
 and notice the difference by feeling, for the larynx rises for the 
 higher tones and sinks for the deeper ones." 
 
 Not every stammerer, however, is lacking in general 
 auditory imagery. The replies to the writer's ques- 
 tionnaire ^ show (if they may be regarded as reHable) 
 that the imagery is sometimes fairly strong. As re- 
 gards the acoustic imagery of ordinary physical sounds 
 and music, the repHes exhibited the two extremes as 
 well as the different degrees between them. In some 
 cases there was no memory whatever for ordinary 
 
 1 One of these had incurred his impediment through imitation. 
 
 2 The Voice, Vol. I, p. 112 (from a translation of "Die Heilung 
 des Stotterns"). 
 
 « Albert Gutzmann, "The Cure of Stuttering" {The Voice, Vol. V, 
 p. 83). * About two dozen sets of answers were received. 
 
250 THE PSYCHOLOGY OF STAMMERING 
 
 sounds, and in other cases most sounds were appar- 
 ently represented. 
 
 There seems, however, to be no necessary parity 
 between the acoustic memory for ordinary sounds and 
 the acoustic memory for words. Ballet says in refer- 
 ence to this matter : ^ 
 
 "We know a distinguished musician that is endowed with a 
 remarkable memory for sounds; but he recalls words by in- 
 voking his visual rather than his auditory memory." 
 
 The existence of clear musical imagery or clear 
 general auditory imagery does not therefore necessarily 
 indicate the existence of a clear auditory memory for 
 words. 
 
 The writer's correspondents were unanimous in the 
 statement that they both heard and felt their words 
 when thinking them. The acoustic element seemed 
 subject to a good deal of variation, some correspond- 
 ents stating that the thinking voice resembled the 
 speaking voice in timbre, volume, etc., and others 
 stating that verbal thought took place in "a sort of 
 standard thinking voice"; i.e. in a voice in which 
 the acoustic element must be decidedly weak. AU 
 agreed, however, that the acoustic element was pres- 
 ent. This, of course, is exactly what one would 
 expect. 
 
 But it seems probable that the average stammerer 
 
 1 "Le langage interieur et I'aphasie," 2d ed., p. 28. 
 
STAMMERING 251 
 
 has weak rather than strong auditory verbal imagery. 
 It would not be surprising to find that this imagery is 
 relatively strong in a small minority, for the stam- 
 merer's difficulty is not occasioned by deprivation 
 or weakness of the auditory imagery, but by tran- 
 sient auditory amnesia. The stammerer has audi- 
 tory imagery, and he relies upon it in speech. 
 Even after the occurrence of the amnesia, the 
 acoustic image must ultimately appear; for if 
 this were not the case, the stammerer would be 
 permanently aphasic. The imagery may, then, in 
 some cases be strong (though one must be conservative 
 in interpreting the statements of non-psychologists) ; 
 but the amnesia may appear, none the less. The in- 
 ducing cause of stammering — the emotional shock, 
 fever, or whatever it be — may effect not so much a 
 general enervation of the auditory verbal centre as a 
 functional perversion that renders transitory amnesia 
 hkely to supervene. But if this were the case, it 
 would be the person with congenitally weak auditory 
 imagery that would be most likely to suffer. The 
 weakness of the imagery would itself be a predisposing 
 cause. It would render the amnesia more Kable to ap- 
 pear and more difficult to overcome. For this reason 
 one is impelled to the belief that the average stam- 
 merer has weak rather than strong acoustic imagery. 
 The weakness of the imagery is probably in most 
 cases a congenital rather than an acquired defect, the 
 
252 THE PSYCHOLOGY OF STAMMERING 
 
 acquired defect being a functional perversion that at 
 times subverts the imagery that is already dangerously 
 near the point of extinction. When the imagery is 
 congeni tally strong, the same functional defect might 
 merely lower its intensity without affecting oral speech. 
 
 It would be quite possible, though, for a general 
 weakening of the auditory imagery to induce stammer- 
 ing. The stammering would be more likely to appear 
 if there existed a neurotic tendency that rendered 
 the intensity of the imagery variable. The imagery 
 would then vacillate near its minimum intensity and 
 would repeatedly disappear from consciousness. The 
 combination, weakness of imagery and variability in 
 intensity, would be sufficient to occasion stammering 
 in any person dependent upon auditory cues ; and if 
 either of these causes were extraneously introduced 
 when the other was already existent, the impediment 
 would be estabHshed. 
 
 It is also quite conceivable that a general enervation 
 of the auditory verbal centre might induce stammering 
 even if there existed no marked tendency to variability 
 in the imagery. The general lowering of the intensity 
 of the auditory imagery would probably entail obHtera- 
 tion of some of the less distinctive vowel-colors, and a 
 somewhat equable form of stammering would result. 
 This cause is probably operative in some cases where 
 temporary stammering occurs during the course of a 
 disease or during the succeeding convalescent period. 
 
STAMMERING 253 
 
 Variability in the intensity of mental imagery is 
 normal, though extreme or sudden variations probably 
 occur only when there exists a neurotic tendency or 
 some cerebral functional perversion. 
 
 Angell says of the normal mental imagery : ^ 
 
 "To-day this may be principally auditory and verbal, to-mor- 
 row largely visual. It may be on the one occasion vivid and 
 detailed, and on the other evanescent and whoUy schematic." 
 
 Changes in theverbal imagery are likewise normal and 
 common. In his "Motorische Wortvorstellungen," 
 Dodge describes the mutations in the verbal imagery 
 of a theological student. The imagery was generally 
 auditory-motor, but at times it assumed a purely 
 auditory form : 
 
 "One day he told me that his verbal imagery had been 
 purely auditory during the course of the preceding evening. 
 Not the slightest trace of movement-images was present. 
 This he had determined during a period of quiet introspection. 
 At the time that he made this communication to me, the motor 
 element was again the prominent, and apparently the exclusive, 
 [?] constitutent of his mental speech. He informed me on 
 subsequent occasions that the motor element in his verbal 
 thought would sometimes completely disappear for several hours. 
 
 "He was not able to produce this change in the character 
 of his verbal imagery at will. The auditory verbal imagery 
 seemed to confine itself to hours of quietness and repose. Apart 
 from this, no regularity could be observed." ^ 
 
 1 "Psychology," p. 253. 
 
 '"Motorische Wortvorstellungen," p. 36. 
 
254 THE PSYCHOLOGY OF STAMMERING 
 
 It is probable that the motor images disappeared 
 when the auditory images became sufl&ciently intense 
 to represent the verbal thought independently. This 
 particular case shows only the intensification of the 
 auditory imagery. Its obfuscation may or may not be 
 common among persons of normal speech ; but it is 
 certainly common among stammerers. A correspond- 
 ent says, in reply to the questionnaire : 
 
 "When thinking in words, I sometimes hear them and some- 
 times seem to be mentally articulating them. When my speech 
 has been annoying me, I always think in the latter way." ^ 
 
 The latter remark suggests that failure to hear the 
 words was the cause of the stammering. The remark 
 is significant: it supports the behef that a general 
 obfuscation of the auditory imagery renders the amnesia 
 more Hable to appear and more difficult to overcome. 
 
 The increase or decrease in the intensity of the men- 
 tal imagery may endure for hours, days, weeks, or 
 months. The mutations are primarily attributable to 
 minor changes in the physical condition, — physical 
 changes in the nervous system that do not always 
 manifest themselves in definite feeHngs. Fatigue, 
 sleeplessness, or an attack of indigestion may 
 obfuscate the mental imagery, and the stammerer 
 finds that for some unaccountable reason he is ex- 
 periencing greater difficulty in speech. On the other 
 
 ^ The correspondent knew nothing of the theory advanced in this 
 monograph. 
 
STAMMERING 255 
 
 hand, the tone of the nervous system may tempora- 
 rily improve, and forthwith the auditory imagery is 
 intensified. All traces of the impediment may disap- 
 pear, and for a time the stammerer enjoys complete 
 immunity from his defect. If the improved tone of 
 the nervous system is due to a change of climate, the 
 stammerer may have no difficulty in speech for weeks 
 or months at a time. But the speech-disorder re- 
 curs as soon as he becomes acclimated, or as soon as 
 some minor physical disturbance adversely affects 
 him. 
 
 These mutations in speech-disturbances may or 
 may not be due exclusively to the vicissitudes of the 
 auditory imagery, but certainly they are attributable 
 to them in large part. 
 
 The desideratum in speech is either strong auditory 
 imagery or no auditory imagery at all. The strong 
 imagery renders one immune from speech-disturbances 
 when slight variations in its intensity occur; the 
 absence of the acoustic imagery renders variation im- 
 possible. It is the fugacious and vacillating auditory 
 imagery that causes the stammerer's trouble. The 
 auditory imagery is always, as it were, in unstable 
 equihbrium. The sound-image is continually disap- 
 pearing from consciousness, and the stammerer is left 
 strugghng for a foothold in space. ^ 
 
 ^ The reader that is a non-stammerer can readily comprehend the 
 nature of a fugitive image by watching the gradual evanescence of a 
 
256 THE PSYCHOLOGY OF STAMMERING 
 
 It is interesting to note that many authorities regard 
 stammering as an hereditable defect. Wyneken says 
 on the matter : ^ 
 
 " One cannot escape the fact that there exists in many cases 
 a certain inborn predisposition to stammering, which cannot 
 be eradicated by the most careful training." 
 
 Denhardt regards stammering as inheritable. 
 Among 1994 cases of stammering he found evidence of 
 heredity in 1545 ; that is, in approximately 77I per 
 cent.^ 
 
 Doubtless many cases of stammering ascribed to 
 heredity are in reahty due to imconscious imitation. 
 
 visual after-image. Let him take a small square of red paper and 
 place it upon a white background. Let him. then fixate a pin-prick 
 at the middle of the square for 15 or 20 seconds. When the square 
 is removed, a green after-image will appear upon the paper. 
 
 This after-image assumes various degrees of vividness. At first 
 the outline is well defined, and the color intense. Gradually the 
 sharp boundaries disappear, the angles vanish, and the contour is 
 obliterated. Simultaneously the color fades, and finally nothing 
 remains but a dim, colored haze. In its turn, this haze disappears, 
 and the after-image has vanished. 
 
 This after-image may be regarded as illustrating the various 
 degrees of intensity in auditory images. The ideal auditory image 
 for the incitation of speech is the one analogous to the square with 
 its sharpest outhne and coloration. The image as it exists in many 
 persons — and probably in most stammerers — is comparable 
 to the after-image shortly before its disappearance. The amnesia 
 of stammering is represented by the visual blank by which the image 
 is succeeded. 
 
 ^ "Ueber das Stottem und dessen Heilung," p. 10. 
 
 2 "Das Stottem eine Psychose," p. 91. 
 
STAMMERING 257 
 
 But this explanation will not hold in all cases, for 
 often there is no association between the related stam- 
 merers. In the latter cases there is probably an 
 inherited weakness of the auditory imagery or an in- 
 herited neurotic tendency entaihng marked variability 
 in the imagery. Either of these factors would predis- 
 pose the child to stammering ; and if the other factor 
 should supervene, the speech-disturbance would be 
 estabhshed. In some cases it is probable that both 
 factors are inherited — though not necessarily 
 from the same parent; and the child might then be 
 said to inherit his stammering.^ The stammering 
 might not develop if the neurotic tendency were to 
 manifest itself at an early age, for the child would then 
 probably learn to depend upon his kinaesthetic imagery. 
 But if the neurotic tendency were not displayed till 
 the child had acquired command of language, stam- 
 mering would inevitably ensue. 
 
 The form of stammering that has been considered 
 up to this point is pure stammering; i.e. stammering 
 directly due to auditory amnesia, and uncompHcated 
 by extraneous symptoms. The bhnd struggles of the 
 stammerer — the facial contortion and physical eflfort 
 — are mere epiphenomena. They are secondary 
 
 ^ Davenport gives pedigrees of two stammering families in his 
 "Heredity in Relation to Eugenics." He inclines to the view that 
 stammering is a recessive characteristic. It is probably incorrect, 
 however, to regard stammering as a imit character. 
 
258 THE PSYCHOLOGY OF STAMMERING 
 
 manifestations of the defect. This latter form of 
 stammering may be designated secondary, or physical, 
 stammering. The third form of the defect, acquired 
 kincBsthetic stammering, is due, Hke the first, to mental 
 causes. It is stammering occasioned by perversion or 
 distortion of the mental imagery of speech. This per- 
 version of the verbal imagery may result from as- 
 sociation with or imitation of other stammerers, or it 
 may arise as the direct result of one's own stammering, 
 the process being, as it were, one of auto-intoxication, 
 or self-infection. 
 
 We shall now consider the characteristics of these 
 forms of stammering a Kttle more closely. 
 
 Pure Stammering 
 
 The forms of stammering directly due to auditory 
 amnesia may be roughly classified. The classifica- 
 tion is of no particular value except that it serves to 
 establish one's conception of pure stammering. 
 
 When pure stammering manifests itself on the con- 
 tinuous consonants, it usually takes the form of a pro- 
 longation of the initial sound. In the word few, for 
 instance, a continuous fricative sound is produced till 
 the vowel appears. If the initial consonant happens 
 to be sonant, a continuous vocaHzation accompanies 
 its production. Strictly speaking, the vocahzation is 
 part of the consonant, for without vocaHzation the 
 consonant would be surd. It sometimes happens, 
 
STAMMERING 259 
 
 however, that the '^ sonant" consonants are produced 
 without voice. This surdal stammering on the con- 
 tinuous sonant consonants can be regarded as pure, for 
 the prolongation of the consonant is directly due to the 
 auditory amnesia. 
 
 A form of interruptive or repetitive stammering 
 sometimes occurs on the continuous sonant consonants. 
 This form of the defect is frequently ^'diagnosed" as 
 stuttering. It is evident that the distinction between 
 stammering and stuttering is artificial. Repetitive 
 stammering is not due to disturbances in respiration 
 or to occlusions of the glottis, but rather to the execu- 
 tion of articuiative movements that are not directly 
 succeeded by the vowel. The stammerer attempts 
 to say six, but produces a series of short sibilant 
 sounds. The word then becomes s-s-s-six. He at- 
 tempts to say London, but repeatedly articulates a 
 surdal or sonant L. In both cases the stuttering 
 articulation is directly occasioned by failure of the 
 auditory image. Occasionally a silent pause occurs 
 between the consonant and the vowel. This form of 
 stammering rarely appears, however, on the con- 
 tinuous consonants. 
 
 All other forms of stammering on continuous con- 
 sonants, such as manifestation of Hngual or labial 
 effort, must be regarded as secondary. 
 
 There are three different varieties of pure stammer- 
 ing on the explosive consonants. The first variety is 
 
26o THE PSYCHOLOGY OF STAMMERING 
 
 the disjointed speech described by Kussmaul, in which 
 there is a distinct lacuna between the consonsant and 
 the vowel. Instead of saying Kommeh and Kaffee, 
 the speaker says K — h — ommen and K — h — afee. He 
 articulates the consonant, — using kinaesthetic cues, — 
 then waits passively for the auditory image to appear. 
 This particular form of stammering exactly reflects 
 the verbal image of the word. It is the purest form of 
 stammering that can occur on the explosive consonants. 
 In the second form of stammering on explosive con- 
 sonants the articulatory organs are held passively in 
 position till the auditory image rises in the mind. 
 The word is articulated as soon as the sound-image ap- 
 pears, and no marked incoordination is perceptible to 
 the ear, — a delay only is heard. The stammering ap- 
 peals chiefly to vision ; it can be seen that the articu- 
 latory organs take their initial position and hold it 
 for an abnormal length of time. This form of stammer- 
 ing is really somewhat of an accomplishment : it is the 
 stammering of the virtuoso. The stammerer essays 
 to retard the consonant — without repeating it, or 
 ''holding" it with undue pressure — till the vowel is 
 ready to appear. The difflculty is, however, that the 
 stammerer cannot always tell just when the vowel is 
 ready to appear ; and when he produces the consonant, 
 he may find that his articulation has been premature, 
 and before he finally gets the vowel, the stammering 
 may be decidedly evident. 
 
STAMMERING 261 
 
 The third variety of stammering on the explosive 
 consonants takes the repetitive form. The sonant 
 consonants are sometimes produced as surdal, but the 
 surd consonants are practically never vocahzed. 
 
 This exhausts our classification of pure stammering. 
 
 The assertion is made by some writers that stam- 
 mering occurs more frequently on the explosive con- 
 sonants than on the continuous consonants. The 
 disparity is sKght, if it exists. There seem, however, 
 to be mechanical and psychological reasons why 
 greater difficulty should be experienced in subjoining 
 the vowels to the closed consonants ; hence, if stammer- 
 ing does occur more frequently on these consonants, 
 the fact need not indicate that the consonants them- 
 selves are difficult. 
 
 When a word commencing with a sonant explosive 
 consonant {B or D, for instance) is articulated, 
 vocahzation commences in advance of articulation. 
 When the articulatory movement is produced, the 
 vowel must follow instantaneously; otherwise stam- 
 mering results. Vocalization is already under way, 
 and the vocal stream must be shaped immediately 
 to the appropriate vowel. With the surd explosive 
 consonant (P or T, for instance), no less dexterity is 
 required. The consonant is exploded by a non- 
 vocaHzed stream of breath ; but as soon as articulation 
 takes place, the stream of breath must be vocahzed 
 
262 THE PSYCHOLOGY OF STAMMERING 
 
 and given its requisite color. If for any reason the 
 latter process is delayed, stammering results. It is 
 evident, then, that for fluent enunciation of words 
 commencing with explosive consonants, the auditory 
 image must be at the instant command of the speaker. 
 The slightest delay in its appearance produces abnor- 
 mal speech. 
 
 So dehcate a control of the vowel is not required for 
 the continuous consonants. The speaker commences 
 the initial consonant — a F or an If , for instance — 
 and sustains it till the vowel appears. Instantaneous 
 production of the vowel is not necessary, for it makes 
 no difference whether the consonant be continued for a 
 fiftieth part of a second or for a whole second. Hence 
 a less delicate control of the auditory image is re- 
 quired. If the vowel is delayed for a half a second, the 
 consonant is continued so much longer. The contin- 
 uous consonants can be continued, but the explosive 
 consonants can not. If the vowel is delayed for a half 
 a second with the closed consonants, stammering must 
 inevitably result. 
 
 These facts should account for whatever disparity 
 exists in the amount of difficulty experienced with 
 the two forms of consonants. There is another fact 
 that might account for the more frequent occurrence 
 of stammering on the closed consonants. Physical 
 stammering is usually greater on these consonants ; 
 hence they are more likely to be affected by acquired 
 
STAMMERING 263 
 
 kinaesthetic stammering due to distortion of the mental 
 imagery. This matter will be better understood after 
 the subject of distorted imagery has been more fully 
 discussed. 
 
 Secondary, or Physical, Stammering 
 
 It will be noticed that up to this point practically 
 nothing has been said concerning labial and glottal 
 " spasms," " paroxysms of stammering," etc. These 
 ^'spasms" constitute nothing more nor less than the 
 stammerer's misdirected efforts to overcome his 
 difl&culty. They are often regarded, however, as the 
 primary defect. The following paragraph exhibits a 
 fairly typical point of view : 
 
 "The most distressing cases are those in which the spasm 
 extends to parts unconnected with speech, — it may be to 
 nearly the whole muscular organism. In such a case the 
 spasm commences, let us assume, at the base of the tongue ; 
 the mouth opens widely and remains in that position; the 
 muscles of expiration work convulsively ; the glottis contracts ; 
 respiration becomes arrested ; the face becomes congested and 
 the veins dilated; violent spasmodic movements involve the 
 trunk and limbs ; and only after some time, either when the 
 patient becomes exhausted, or when he resolutely restrains 
 his attempt to articulate, does his paroxysm come to an end."^ 
 
 These " spasms " are, of course, neither the stam- 
 mering nor the cause of the stammering. Strictly 
 speaking, stammering is httle more than a failure of 
 
 1 "Quain's Dictionary of Medicine," ist ed., p. 1513. 
 
264 THE PSYCHOLOGY OF STAMMERING 
 
 speech due to the non-appearance in consciousness of 
 the auditory image. It is the inabihty to complete a 
 word that may or may not have been begun. The 
 primary disturbance is essentially passive. The 
 ''spasms" and contortions are nothing but an excres- 
 cence on the disorder. They are the bhnd and impo- 
 tent struggles of the stammerer against an invisible 
 adversary. Physical stammering is purely volim- 
 tary. It is not always dehberate : it is often the prod- 
 uct of bewilderment. But it is voluntary in this 
 sense — that it can at any moment be inhibited. 
 Often the stammerer summarily relinquishes the at- 
 tempt to speak, and thereupon the so-called paroxysm 
 is at an end. Physical stammering is occasioned 
 solely by the speaker's ignorance of the real nature 
 of the disturbance. When the vowel-image fails to ap- 
 pear, the consonant is either not articulated or it is 
 rapidly repeated. Hence the stammerer sees in the 
 consonant the apparent cause of his difficulty, and 
 resorts to physical effort to overcome it. He presses 
 the Kps together, tightens the muscles of the throat, 
 clenches the fists, and may work even his arms and 
 legs in an effort to articulate. But, since articulation 
 itself causes no difficulty, his efforts are entirely mis- 
 directed. 
 
 Physical stammering may, in many cases, lead to 
 obfuscation of the verbal imagery. A case is on 
 record in which a subject could stop his internal 
 
STAMMERING 265 
 
 language by simply holding the breath.^ The average 
 person with marked kinaesthetic images of speech 
 will find that the act of inhibiting respiration restrains 
 the internal language. Thus it is clear that physical 
 stammering may aggravate the amnesia. 
 
 The brain expands more during expiration than dur- 
 ing inspiration.^ This being the case, it is evident 
 that the common practice of stammerers of exhausting 
 the breath may increase cerebral congestion, and thus 
 likewise aggravate the amnesia that directly induces 
 stammering. 
 
 The secondary manifestations of stammering are so 
 multiform that the task of classifying them would be 
 arduous to the last degree. The writer has no in- 
 tention of undertaking the task, for the work would be 
 worthless when complete. Ssikorski has written a 
 chapter on the symptomatology of stammering, and 
 he commences it as follows : ^ 
 
 "The manifestations of stammering are so varied and com- 
 plicated that the investigator engaged on this neurosis must 
 perforce ask himself whether there exists a single disturbance 
 or a number of disturbances that have been grouped together 
 on account of insufficient analysis. The external manifesta- 
 tions are so diverse that it seems impossible to compare and 
 classify the symptoms of the different cases." 
 
 ^ Annales Psychol., January, 1893, p. 103. (Quoted by Baldwin, 
 "Mental Development of the Child and Race," p. 434.) 
 2 Leonard Hill, "Cerebral Circulation," p. 13. 
 ' "Ueber das Stottern," p. 44. 
 
266 THE PSYCHOLOGY OF STAMMERING 
 
 The succeeding 143 pages of Ssikorski's monograph 
 contain his attempt to correlate the various ''spasms" 
 that occur in stammering. All the different '^ spasms " 
 are classified and described — from those in the upper 
 lip to those in the lower extremities. The work is a 
 monument to the author's thoroughness and patience, 
 but its value is unfortunately neghgible. 
 
 A remark may be made at this point concerning the 
 frequent self-exacerbation of physical stammering. 
 It will be remembered that a muscular movement is 
 initiated by a mental image of its resident or remote 
 effect. The resident effect is the kinaesthetic sensation. 
 K this resident sensation gets to the focus of attention 
 during the mental hiatus occasioned by the auditory 
 amnesia, it may, apparently, augment the muscular 
 contraction by assuming the function of the inciting 
 image. The excessive muscular contraction that 
 results constitutes a pseudo-spasm; and it is this 
 "spasm" that has led the objective observer astray. 
 But, as already stated, there is no spasm in the real 
 sense of the word. At any moment the will can step 
 in and inhibit the process. All that is necessary is 
 that something other than the kinaesthetic sensation 
 be placed at the focus of attention. To secure this 
 condition the stammerer has often to rehnquish the 
 attempt to speak. 
 
 The following paragraph gives James's account of 
 
STAMMERING 
 
 267 
 
 the manner in which a sensory stimulus normally 
 brings about a motor response. (Figure 6, to which 
 the letters refer, represents the nervous system re- 
 duced to its fewest possible terms.) 
 
 Motor Cell 
 
 Muscle «^ 
 
 ^> Sensory Cell 
 
 ^ Eineesthetic GeQ 
 
 Sense-organ 
 
 Fig. 6. 
 
 "A stimulus reaching the sense-organs awakens the sensory 
 cell, S; this by the connate or instinctive path discharges the 
 motor ceU, M, which makes the muscle contract ; and the 
 contraction arouses the second sensory cell, K, which may be 
 the organ either of a 'resident' or 'kinaesthetic,' or of a 'remote' 
 sensation. The cell K again discharges into M. If this were 
 the entire nervous mechanism, the movement, once begun, 
 would be self-maintaining,^ and would stop only when the parts 
 were exhausted. And this, according to M. Pierre Janet, is 
 what actually happens during catalepsy." ^ 
 
 Each elementary movement must be regarded as 
 possessing its own motor circle. The complex move- 
 ments required for the articulation of a word would 
 involve several motor circles. 
 
 ^ This circle of neural activity James calls the "motor circle." 
 2 James, "Principles of Psychology," Vol. II, p. 582. 
 
268 THE PSYCHOLOGY OF STAMMERING 
 
 In regard to the continuous discharge through a 
 a motor circle, James says : ^ 
 
 "We should all be cataleptics and never stop a muscular 
 contraction once begun, were it not that other processes si- 
 multaneously going on inhibit the contraction. Inhibition is 
 therefore not an occasional accident; it is an essential and 
 imremitting element of our cerebral life." 
 
 The inhibition is brought about by the transference 
 of attention from one term to the next in a concate- 
 nated series. The attention is always directed toward 
 the ultimate result to be achieved, and the completion 
 of one elementary movement is the signal for attention 
 to move on to the next. If, however, one of the 
 members of the series fails to appear — the remote, 
 auditory image of the vowel, for instance — the ac- 
 tivity in the preceding motor circle is unduly pro- 
 longed; and if the kinaesthetic sensation from the 
 movement comes to the focus of attention, the 
 muscular contraction may be greatly intensified. In 
 fact, the stammerer may be able to inhibit activity 
 in the motor circle only by relinquishing the attempt 
 to speak. 
 
 The foregoing is an attempt to explain in a rather 
 elementary way the rationale of a pseudo-spasm. No 
 attempt has been made to solve the question as to 
 what length the muscular contraction can be automati- 
 cally continued after it has been voluntarily begun. 
 
 * Loc. cit., p. 583. 
 
STAMMERING 269 
 
 The attempt would lead to an almost interminable 
 discussion concerning theories of different ''levels" of 
 attention. The discussion itself would lead nowhere ; 
 hence it is best omitted. It is certain that activity 
 in the motor circle is voluntarily initiated, and that it 
 can at any moment be voluntarily discontinued. The 
 whole subjective aspect of the matter can be summa- 
 rized in the statement that the wrong element gets to 
 the focus of attention. Instead of the verbal image of 
 a word, there is placed at the focus of attention a 
 kinaesthetic sensation of muscular contraction. This 
 abnorm.al condition intensifies the physical stammer- 
 ing. 
 
 But, let it again be emphasized that the pseudo- 
 spasm is purely a secondary manifestation of stammer- 
 ing, and is never the cause of the defect. It is itself 
 indirectly induced by the failure of the auditory 
 image; but when the auditory image appears, the 
 pseudo-spasm is at an end. 
 
 Stammering due to Distortion of the Verbal 
 
 Imagery 
 
 In some cases the afferent sensations from physical 
 stammering impress themselves upon the memory of 
 the stammerer and distort his verbal imagery. His 
 verbal images of words are then perverted by kinaes- 
 thetic images of labial or Hngual pressure, or by 
 images of recurring articulation. It can therefore be 
 
270 THE PSYCHOLOGY OF STAMMERING 
 
 said with truth that it is in certain cases more difficult 
 for the stammerer to think some words than it is for 
 him to think others; his difficulty is not necessarily 
 conffiied to their enunciation. In thinking, he may 
 ffiid that his verbal imagery is at times somewhat con- 
 strained by the disappearance of the auditory nucleus ; 
 but this imagery may be also encumbered by mental 
 feeHngs of muscular effort and labored articulation, 
 the consonant appearing in thought much as it appears 
 in speech. It is probable that this articulatory 
 stammering occurs in the mental words of the amnesic 
 stammerer only when the auditory image fails to 
 appear in the mind. It would be the invariable 
 concomitant of a particular mental word if the word 
 invariably occasioned difficulty. However, the 
 stammerer usually has difficulty only under certain 
 conditions ; hence he may speak a word fluently 
 more frequently than he stammers upon it, and the 
 sensations from stammering are offset by the more 
 frequent feeHngs of free articulation. 
 
 The replies to the writer's questionnaire show that 
 mental stammering exists in a majority of cases. 
 The correspondents were not asked, however, to 
 differentiate kinassthetic stammering from auditory 
 amnesia. Either phenomenon is mental stammering, 
 but the average non-psychologist could not be expected 
 to give rehable information concerning the extent to 
 which the conditions exist independently of each other. 
 
STAMMERING 271 
 
 The voluntary imitating of stammering or stuttering 
 at times effects a perversion of the kinaesthetic and au- 
 ditory verbal imagery. Since the verbal image is par- 
 amount in determining the nature of the spoken word, 
 the simulant then becomes a stammerer in reahty, and 
 pays the penalty for his folly by serving as a butt for 
 other witlings. When stammering is induced by imita- 
 tion, it does not assume the amnesic form ; the speech- 
 derangement is occasioned by the distortion of the 
 verbal imagery, and not by failure of " internal 
 hearing." The act of imitating stammering affects 
 the kinaesthetic images more directly, but it probably 
 affects the auditory imagery also, when this happens 
 to be strong. It seems not unhkely that auditory 
 imagery is weak in persons that acquire stammer- 
 ing through voluntary imitation. If the auditory 
 imagery were weak, it would not easily counteract 
 the effect of a slight perversion of the motor 
 memory. On the other hand, it might be argued 
 that if the auditory imagery were strong, it 
 would itself be more easily distorted. However, the 
 auditory imagery is rectified by the acoustic impres- 
 sions that the stammerer receives when Hstening to the 
 speech of other persons. His kinaesthetic imagery is 
 probably not corrected by these impressions. 
 
 It seems improbable that the mere act of imitating 
 stammering or stuttering should effect organic changes 
 in the brain-cells or fibres. The act of imitating 
 
272 THE PSYCHOLOGY OF STAMMERING 
 
 stuttering might perhaps induce an exalted excita- 
 bihty of the motor centres concerned in speech, and 
 there would then result a species of reflex stuttering. 
 It seems unlikely, however, that such a condition 
 occurs. The cause is more probably psychological. 
 But if even a temporary disturbance in the motor 
 centres were to exist, a perversion of the speech-im- 
 agery might ensue, and the impediment would then 
 be estabHshed. 
 
 Acquired stammering is, in most cases, soon con- 
 firmed by the development of fear and by mental 
 confusion resulting from the attempt to avoid difficult 
 words by the use of synonyms. These complicating 
 causes will be discussed in the two succeeding chapters. 
 
 Stammering is often acquired by children as the 
 result of association with other stammerers. What- 
 ever a child learns, he learns chiefly through imitation. 
 If those around him speak English, he speaks EngHsh. 
 If those around him use provincialisms, he uses 
 provincialisms. If those around him stammer, he 
 learns to stammer also. To him stammering may, 
 indeed, appear as a normal mode of speech — or it 
 might if he were able to reflect upon the matter. 
 What really happens is that he hears stammering, and 
 acquires distorted images of speech by the same 
 process that would under other conditions inculcate 
 normal verbal imagery. With his imagery dis- 
 torted, he must stammer as a consequence. When the 
 
STAMMERING 273 
 
 child is associated with both stammerers and normal 
 speakers, he may acquire either natural or abnormal 
 speech. The matter will be determined entirely by 
 the nature of the speech of the persons from whom 
 he acquires the greater part of his instruction or 
 whom he imitates most frequently. 
 
 A child's mental imagery may become distorted 
 through association, even after he has acquired a 
 thoroughly norm.al utterance. If he comes into fre- 
 quent contact with stammerers at the age of six 
 or seven, his speech may become affected through in- 
 voluntary imitation. It is the auditory imagery that 
 is first affected ; but the kinassthetic imagery may be 
 indirectly affected by the fact that the auditor takes 
 the words of the speaker, as Bain expresses it, into a 
 "vocal embrace." Ultimately both forms of imagery 
 must become affected, for the child feels his stam- 
 mering, even if this is originally induced by auditory 
 cues.^ 
 
 It follows from the foregoing discussion that one's 
 verbal imagery might become distorted as the result 
 of a speech-disturbance due to purely temporary 
 
 ^ Children have, of course, a decided propensity for imitating most 
 of the abnormal conditions that they observe; and they imitate 
 chorea, epilepsy, etc., just as readily as they imitate stammering. It 
 is related of Boerhaave that he once had to contend with an epidemic 
 of epilepsy at the Haarlem Orphan Asylum. He had several pairs of 
 red-hot tongs prepared in a huge brazier in one of the halls. He then 
 called the children together, and told them that he had given orders 
 
274 THE PSYCHOLOGY OF STAMMERING 
 
 causes. After the disappearance of the inducing 
 cause, the impediment might persist as a consequence 
 of the distorted imagery. Stammering would then be 
 due, as it were, to self-imitation, and would continue 
 in spite of the absence of auditory amnesia. When 
 stammering of this kind exists, it probably manifests 
 itself impartially under all conditions. When there 
 is variability in the impediment, the disturbance is 
 complicated by other causes. 
 
 There remains now only one of the pecuHarities of 
 stammering to be accounted for — the fact that the 
 disturbance usually makes its appearance during child- 
 hood. The primary reason for this fact is that the 
 child is more susceptible during his early years to those 
 causes that induce stammering. One of the most 
 prolific causes of stammering is fright. The child is 
 exposed to this cause on account of his inexperience. 
 Objects and occasions that induce fright in early years 
 have no such effect in later life, for the reason that 
 they are better understood. 
 
 Infectious fevers are also among the principal cause 
 
 for all of them that had epileptic fits in future to be promptly branded. 
 This somewhat questionable procedure apparently terminated the 
 epidemic (see Mosso, "Die Furcht," p. 233). Similar epidemics of 
 imitative stammering seem to occur at times in different communities. 
 To explain this involuntary imitation one must, of course, explain the 
 morbid imitative propensity as well as the mental process by which 
 the imitation proceeds. 
 
STAMMERING 275 
 
 of stammering. These fevers generally occur during 
 the earUer years of one's life. Measles, scarlet fever, 
 chicken pox, etc., are usually the illnesses of childhood. 
 It would be safe to say that, with the average person, 
 a majority of the infectious fevers that he suffers 
 during lifetime occur before he is ten years of age. 
 
 During the early years of Hfe, when the child is 
 susceptible to the inducing causes of stammering, the 
 mental imagery is in an unstable condition, and is 
 probably for this reason more Hable to derangement. 
 Loss of one of the senses during early childhood re- 
 sults in total obHteration of the corresponding mental 
 imagery. This fact shows that the mental images are 
 only superficially enregistered in the cells. It seems, 
 therefore, reasonable to suppose that a relatively slight 
 disturbance may affect the mental imagery. More- 
 over, if the child inherits weak auditory imagery, he 
 is already predisposed to stammering, and naturally 
 succumbs to the first inducing cause. 
 
 The infrequent appearance of stammering in adult 
 life is accounted for by the more secure estabhshment 
 of the kinassthetic verbal imagery. A minor form 
 of auditory amnesia is less likely to affect oral speech 
 after a person has had twenty or thirty years of 
 practice in the correct use of the speech-organs. This 
 latter circumstance affords an explanation for the fact 
 that functional aphasia occurs more frequently in 
 children during fevers than it does in adults. Greater 
 
276 THE PSYCHOLOGY OF STAMMERING 
 
 clearness of the auditory imagery in girls may account 
 for the fact that these functional disturbances are less 
 common among them than among boys.^ However, 
 stammering can develop at any time in Hfe if the audi- 
 tory amnesia is sufficiently severe and the patient is 
 an audito-moteur. All that is necessary is that there 
 shall be temporary auditory amnesia without kinaes- 
 thetic verbal amnesia. The patient then knows 
 what word he wishes to use, and he knows what the 
 word m.eans. He has a clear kinaesthetic image 
 that permits him to commence its articulation, 
 but no auditory image to enable him to continue. 
 Whenever this condition occurs, stammering results. 
 It is by no means necessary that the inception of 
 stammering be confined to the early years of life; 
 in some cases the speech-disturbance does not begin 
 till after the fortieth year. The reasons, however, 
 have been stated why the impediment generally makes 
 its appearance during childhood. 
 
 A remark may be made at this point concerning the 
 acumen of the average stammerer. It is sometimes 
 thought by ignorant persons that the stammerer 
 is not particularly robust in intelligence ; but the belief 
 is without foundation. The stammerer is not usually 
 mentally deficient, though in many respects he may 
 appear eccentric. His eccentricity is due solely to his 
 * See Wyllie, "Disorders of Speech," p. 391. 
 
STAMMERING 277 
 
 stammering. He frequently uses odd phrases and 
 circumlocutions in order to avoid difficult words, 
 and in this way may appear somewhat outre to 
 persons that do not understand his motives. The 
 stammerer sometimes seems to be actuated by vacil- 
 lating purposes, and in this circumstance may appear 
 eri;atic. In such cases he has a dual purpose in view ; 
 and one purpose — which is not manifest to the casual 
 observer — is to avoid stammering at any cost. He 
 appears erratic merely because his purposes are not 
 fully understood. 
 
 The fact that the stammerer is subject to temporary 
 auditory anmesia under particular conditions does 
 not in the least mihtate against his intelligence. Even 
 if the auditory amnesia were plenary and permanent, 
 the mental faculties would probably remain un- 
 impaired. The mere absence of a particular form of 
 mental imagery does not affect the general intelligence. 
 If evidence were wanting on this point one might 
 cite the case of Hellen Keller. This noted deaf- 
 blind subject is possessed of exceptional intelligence 
 despite the fact that her mind is almost exclusively 
 kinaesthetic and tactual. 
 
 So far as intelligence is concerned, stammerers are 
 normal persons. They probably vary between the 
 two extremes just as do persons of normal speech. 
 Frequently stammering is one of the degenerative 
 marks of genius. In his '' Man of Genius, " Lombroso 
 
278 THE PSYCHOLOGY OF STAMMERING 
 
 cites the following men as stammerers : Aristotle, 
 iEsop, Demosthenes, Alcibiades, Cato of Utica, Virgil, 
 Manzoni, Erasmus, Malherbe, Charles Lamb, Turenne, 
 Erasmus Darwin, Charles Darwin, Moses Mendels- 
 sohn, the philosopher; Charles V, Romiti, Cardan, 
 and TartagHa. 
 
 Chervin ^ cites Boissy d'Anglas, Camille DesmouHns, 
 and the artist David as stammerers. Charles Kingsley 
 and Martin Tupper were also stammerers. With so 
 many of the world's greatest geniuses among stam- 
 merers, one might almost regard stammering as an 
 accomplishment rather than a defect. 
 
 ^ " Begaiement et autres maladies fonctionnelles de la parole," 
 3d ed., p. 32. 
 
CHAPTER VIII 
 MENTAL CONFUSION IN STAMMERING 
 
 The auditory amnesia that we have discussed in 
 the preceding chapter is the proximate cause of stam- 
 mering. There are, however, two collateral causes — 
 mental confusion and fear — that complicate the dis- 
 order. Mental confusion will be the subject of the 
 present chapter. 
 
 When the stammerer finds himself suddenly checked 
 in the utterance of a word, he frequently attempts to 
 elude the word by the use of synonyms. This ruse 
 may succeed if an easy synonym is at once forth- 
 coming; but frequently the synonym that suggests 
 itself is no easier than the word that has been re- 
 jected. In this case there may ensue a veritable 
 avalanche of thought to which no human speech- 
 organs could give expression. The stammerer is 
 then at a standstill till the original word or a synonym 
 is finally expressed in clear-cut mental imagery. 
 
 To take a specific example : The stammerer at- 
 tempts to say the word Thursday, but owing to audi- 
 tory amnesia he finds himself unable to pronounce it. 
 Immediately he decides to substitute another expres- 
 
 279 
 
28o THE PSYCHOLOGY OF STAMMERING 
 
 sion for the refractory word, and while articulation 
 remains in abeyance, numberless periphrases flash 
 through his mind, — ''The day after to-morrow," 
 " In a couple of days," " In a few days," ''In two days," 
 "Perhaps Wednesday or the next day." If none of 
 these expressions are satisfactory, the stammerer 
 may reconstruct the whole sentence — and even pre- 
 ceding sentences — in order to circumvent the difficulty, 
 or he may come back to his original word and struggle 
 with it till he finally utters it. During this bewilder- 
 ment the stammerer frequently goes through all 
 sorts of contortions in an attempt to express verbal 
 thoughts that are chaotic to the last degree. The 
 effort may continue where it started with the original 
 word, the tongue pressing vigorously against the 
 teeth; or each expression as it is thought — far too 
 rapidly for utterance — may give rise to some rudi- 
 mentary change in the disposition of the articulative 
 organs. 
 
 It is manifest that no word could possibly be pro- 
 nounced under mental conditions such as those 
 described. The word Thursday cannot be articu- 
 lated because it is no longer thought. The cir- 
 cumlocutions that suggest themselves flash through 
 the mind so rapidly that no speech-organs could 
 ever express them. The stammerer thinks a whole 
 language in a moment in much the same way as a 
 drowning man recalls half a lifetime in the last few 
 
MENTAL CONFUSION IN STAMMERING 281 
 
 seconds of consciousness. The verbal image is 
 paramount in determining the nature of the words 
 expressed ; hence if no clear-cut verbal image is in the 
 mind, no word can be orally produced. It is no more 
 possible for the speech-organs to produce a word that 
 is not clearly expressed in verbal imagery than it is 
 possible for a gramophone to produce words that are 
 not present on the record. The gramophone repro- 
 duces words as they are spoken into it : the speech- 
 organs reproduce words as they are dictated by the 
 verbal imagery. The verbal imagery is absolute. 
 
 In cases similar to the one just cited, the multiple 
 thought (as we may call the profuse and entangled im- 
 agery just described) is a collateral cause of stammer- 
 ing, being itself induced by the amnesia. But in many 
 instances the multiple thought is the sole cause of the 
 immediate disturbance. The stammerer is speaking 
 with apparent ease and fluency, when suddenly there 
 looms up before him a word that has formerly caused dif- 
 ficulty and that he therefore endeavors to avoid . There 
 then occurs the same frantic search for synonyms, the 
 same avalanche of thought, and the same stoppage in 
 speech. But the disturbance is not induced by audi- 
 tory amnesia : it is occasioned by the fact that the 
 speech-organs cannot express the chaos of the mind. 
 
 Here we may take another concrete example : 
 The stammerer wishes to say, ''How do you like that 
 picture?" As he utters the word you or like he fore- 
 
282 THE PSYCHOLOGY OF STAMMERING 
 
 sees disaster at the end of the sentence. Articulate 
 speech is then and there at an end. The word that 
 is being uttered becomes abortive, its mental image 
 being extruded from the mind by the search for syn- 
 onyms. Innumerable words — sketch, paintings land- 
 scape, masterpiece, canvas, production, performance, 
 and a dozen others — flash through the mind. If the 
 stammerer finds one that he can articulate, he is able 
 to proceed. He then frequently endeavors to hide 
 his dilemma by recasting the sentence. The question 
 then becomes ''What do you think of that painting ?" 
 ''Does that landscape suit your taste?" "Is that 
 canvas to your Hking?" etc. If the stammerer is 
 Httle embarrassed, he may give no evidence of his 
 predicament. He pauses quietly, selects the desired 
 word, and continues when he has the thought satis- 
 factorily framed. 
 
 There is often a tangle of visual images participating 
 in the multiple thought. These may be visual images 
 of words, or visual images of objects. The stammerer 
 is in a shop, let us say, where he has to make a number 
 of purchases. He attempts to ask for a particular 
 article, but stammers hopelessly when he endeavors 
 to name it. Thereupon he decides to ask for one of 
 the other articles first, and to essay the refractory word 
 at a more propitious moment. The chances are that 
 the utmost mental confusion will result. Visual 
 images of the different objects and mental images of 
 
MENTAL CONFUSION IN STAMMERING 283 
 
 words rush through the mind in perfect chaos. Dur- 
 ing this bewilderment, stammering must of course 
 continue; and it is probable that the speaker will 
 not be understood when he at last gives utterance to 
 some half-smothered expression. 
 
 We may consider another case in which visual 
 images are present to add to the bewilderment. 
 The stammerer is asked the way to a certain street 
 or building, and there are different routes that he 
 may describe to the inquirer. The stammerer starts 
 to give directions for a particular route, but finds 
 after a few sentences that he is hopelessly stranded 
 on the name of a street he wishes to mention. It is 
 not essential, however, that this particular street be 
 referred to, for an alternative route may be described. 
 The stammerer then vacillates between the decision 
 to proceed with the original directions and the decision 
 to describe an alternative route ; and there occurs in 
 his mind a tumult of thought in which verbal images 
 and visual images of streets and buildings are tumbled 
 together in hopeless confusion. Meanwhile the phys- 
 ical stammering probably finds expression in a motor 
 circle. The stammering terminates only when clear 
 verbal images arise to mediate the expression of clear 
 oral speech. 
 
 Frequently, during stammering, verbal thought is 
 inhibited rather than confounded. The mind is then 
 a blank, or the entire field of consciousness is engaged 
 
284 THE PSYCHOLOGY OF STAMMERING 
 
 by a visual sensation or a visual image. The stam- 
 merer is asked the name of a particular book, let us 
 suppose, but is afraid of certain words that occur 
 in the title. He makes no attempt to reply, but 
 stands mentally transfixed, gazing at any object that 
 happens to be before him. Or it may happen that a 
 visual image gets to the focus of attention, and the 
 stammerer then stares helplessly at a mental picture 
 of the book or a visual image of its title. For a 
 minute or more he makes no attempt to answer the 
 question, but deliberately suppresses the auditory- 
 motor images of the requisite words. Usually the 
 mind is more proKfic, and the stammerer is able to 
 resort to synonyms. It might seem that synonyms 
 would be unavailing in the present case ; but this is 
 not necessarily true. Often the stammerer would not 
 hesitate to pervert the title in quoting it (believing 
 that any irregularities will be attributed to error), or 
 to improvise a title for himself, or to plead entire 
 ignorance in the matter. 
 
 In many cases of stammering the impediment is 
 in large part due to confusion or inhibition of thought. 
 It then frequently happens that the impediment dis- 
 appears almost entirely in reading and reciting. 
 Under these circumstances the stammerer is not 
 obliged to select his words; consequently mental con- 
 fusion is eliminated. Most stammerers speak with 
 less difficulty when alone. The greater fluency is in 
 
MENTAL CONFUSION IN STAMMERING 285 
 
 this case largely attributable to the fact that the 
 speaker does not try to avoid stammering, and conse- 
 quently does not become bewildered in his effort 
 to avoid difficult words. 
 
 Another possible explanation for the stammerer's 
 occasional fluency in reading has already been sug- 
 gested. The visual impressions may arouse the re- 
 fractory auditory images by association, or they may 
 directly arouse the kinaesthetic images. It will be 
 remembered that the abihty to read aloud is not at all 
 uncommon among aphasic patients, — even when they 
 are quite unable to speak spontaneously. In such 
 cases the explanation is the summation of stimuli or 
 the arousal of refractory images by sensations with 
 which they are associated. This same explanation 
 would apply to the case of the stammerer. It does 
 not, however, account for the stammerer's occasional 
 ability to recite, so we must conclude that the ehmina- 
 tion of bewilderment is also an important factor. 
 
 With a great many stammerers there is no mitiga- 
 tion of the impediment in reading and reciting. In 
 some cases, indeed, the disturbance may be aggra- 
 vated. The exacerbation is produced by the stam- 
 merer's fear and confusion. The increased fear is 
 due to the fact that the stammerer finds himself 
 the centre of attention, and to the fact that he an- 
 ticipates difficulty with particular words. The 
 confusion is occasioned by the stammerer's exploring 
 
286 THE PSYCHOLOGY OF STAMMERING 
 
 in advance in search of difficulty. His attention 
 is not concentrated upon the words he is actually 
 pronouncing : it is divided between these words 
 and those that he knows are to follow. The 
 stammerer, moreover, will often substitute words 
 even in reading, and will interpolate phrases of his 
 own. "Any port in a storm" seems to be the motto. 
 This attempt to paraphrase difficult passages leads, 
 of course, to entangled thought that cannot be ex- 
 pressed. 
 
 The enhancement or mitigation of the impediment 
 in reading and reciting is determined chiefly by the 
 stammerer's mental attitude. When attention is 
 concentrated upon the words that are being spoken, 
 stammering is limited to the amnesic form. (The 
 amnesia may, of course, be augmented to some extent 
 by fear.) When the stammerer endeavors to struggle 
 against the inevitable by paraphrasing passages and 
 meeting trouble in the distance, the impediment is 
 indirectly induced by mental confusion, as well as 
 being directly induced by auditory amnesia. 
 
 A too rapid production of verbal thought has been 
 considered by many investigators to be the proximate 
 cause of stammering. But the stoppage of speech 
 that they have considered is usually due to mental 
 chaos rather than to a rapid production of clearly 
 thought verbal images. These two conditions, mental 
 chaos and a slightly too rapid production of verbal 
 
MENTAL CONFUSION IN STAMMERING 287 
 
 images, must be differentiated. When the verbal 
 images succeed one another too rapidly for utterance, 
 cluttering, and not a stoppage of speech, results. 
 WylHe refers to the former defect in the following 
 words : 
 
 "When the words crowd upon each other so much as to 
 interfere with their distinct articulation, the condition has some- 
 times been called ' Cluttering. '" ^ 
 
 Wyllie then quotes Dr. Clouston's description of 
 a case of this kind : 
 
 "Although 'articulation is normal when slowly performed, 
 the moment ordinary speech begins, the m.ental coordination 
 is lost, and we have a torrent of half -articulated words, follow- 
 ing each other like peas running out of a spout.'" ^ 
 
 This condition does not often occur with persons 
 of normal intelKgence. It is evident that the will 
 to speak is present, but that the speech-mechanism 
 is unequal to the task imposed upon it. When 
 stammering occurs as the result of multiple thought, 
 it is not willed that the rapidly thought verbal images 
 shall be enunciated. The stammerer's purpose is 
 primarily to select a word to which he beheves he can 
 give utterance ; and the mental synonyms that 
 occur in thought are as a rule not even incipiently 
 articulated. The images pass so rapidly through 
 the mind that they could not be expressed even if 
 
 1 "Disorders of Speech," p. 139. 2 i^qq ^//^ p -^^q^ 
 
288 THE PSYCHOLOGY OF STAMMERING 
 
 they occurred in pure kinaesthetic form. Quite fre- 
 quently these verbal images appear in visual form, 
 and hence have no direct effect upon the speech-organs. 
 Multiple thought is mental chaos, and it is not the 
 same mental condition that gives rise to cluttering. 
 
 A condition of speechlessness frequently occurs in 
 normal speakers as the result of mental confusion. 
 It is often the concomitant of emotional excitement ; 
 and the person is speechless with fear, anger, or dis- 
 may. Speechlessness occurs either because there is a 
 failure of verbal thought or because the verbal thought 
 is too tumultuous and chaotic to find articulate ex- 
 pression. This emotional condition frequently gives 
 rise to temporary "stammering" in children. The 
 child attempts to describe something that has deeply 
 impressed him. He gasps and gesticulates, but says 
 nothing. This inhibition is produced by a tangle of 
 thought that probably subsists for the most part in 
 visual terms. The condition is not induced by amnesia, 
 and the child is able to speak with fluency if he is 
 compelled to calm himself before making the attempt. 
 
 The tendency to think in visual terms is not in 
 itself a cause of stammering. There are numberless 
 persons that think almost exclusively in visual images, 
 but they are not necessarily troubled with disorders 
 of speech. The practice of thinking in visual terms 
 may be a serious bar to fluency in speech, for the 
 habitual visualizer does not always readily recall the 
 
MENTAL CONFUSION IN STAMMERING 289 
 
 words necessary for the expression of thought. This 
 paucity of verbal images gives rise, however, merely 
 to hesitancy in speech and not to genuine stammering. 
 
 It is well for the stammerer to bear in mind that 
 any articulate sounds produced by the speech-organs 
 are, in general, reproductions of the verbal imagery.^ 
 The articulative mechanism does not reproduce all 
 that is passing in the mind, but whatever is produced 
 is mentally initiated. When the stammerer prolongs 
 a consonant in speech, he prolongs it also in thought. 
 When he repeats a word, syllable, or consonant in 
 speech, he repeats it in thought. The prolongation 
 of the consonant is due to the amnesia. But the 
 repetition — especially of syllables and words — is 
 usually purely voluntary. The stammerer makes 
 the repetition in order to overcome the resistance, as 
 it were, by the sheer momentum of the articulation. 
 But the speech reflects the thought, and the stam- 
 merer will not always find that this mental repetition 
 affords the best method of procedure. 
 
 It is possible that even cluttering may in some cases 
 represent the verbal imagery, and that the cluttering 
 is subjective as well as objective. A species of clutter- 
 ing sometimes occurs with the stammerer even when he 
 knows clearly what words he wishes to utter. Under 
 the influence of fear the words are produced (or, more 
 
 ^ This remark does not apply to some extraneous sounds that 
 may accompany physical stammering. 
 
290 THE PSYCHOLOGY OF STAMMERING 
 
 accurately, smothered) so rapidly that it seems as 
 though they must be initiated by a sort of generic 
 verbal concept instead of by a series of verbal images 
 clearly expressed in the mind. The stammerer 
 gasps out the first few words of the sentence and 
 is then hopelessly checked by amnesia or by an in- 
 abihty to decide between repeating the sentence and 
 continuing from the point he has already reached. 
 No general statement can be made as to whether this 
 cluttering is mental or physical. In some cases the 
 speech may exactly represent the verbal imagery; 
 in others the verbal imagery may be clear, though it 
 cannot be clearly expressed because it is too rapidly 
 produced and because fear paralyzes the musculature. 
 
CHAPTER IX 
 FEAR AND AUTO-SUGGESTION 
 
 Fear is perhaps the most important of the mediate 
 causes of stammering. The stammerer's fear is 
 somewhat similar to stage-fright. It takes the form 
 of an all-consuming dread that effectively deprives 
 the speaker of muscular control. This fear is difficult 
 for the non-stammerer to understand. It is not 
 merely the fear of incurring ridicule, or the fear of 
 making oneself ridiculous ; it is rather the fear of 
 "travailing with unborn thoughts." It is one of the 
 subjective aspects of stammering that only the stam- 
 merer himself can comprehend. 
 
 Schulthess has compared the stammerer's fear to 
 hydrophobia, and he named the condition "Phono- 
 phobia," or ''Lalophobia." Wyneken, having regard 
 to the stammerer's fear of particular words, de- 
 nominated him a "speech-doubter" {Sprachzweifler) } 
 He believed the stammering to be due largely to a 
 wavering of the will during speech ; this vacillation 
 being caused in its turn by the stammerer's lack of 
 confidence in his own speech-organs. Strictly speak- 
 
 * "Ueber das Stotterii iind dessen Heilung," p. 20. 
 291 
 
292 THE PSYCHOLOGY OF STAMMERING 
 
 ing, this latter condition is not fear; it is inhibition 
 of the will due to auto-suggestion. Both fear and 
 auto-suggestion are potent factors in the indirect 
 production of stammering. Denhardt, in his ^^ Stottern 
 eine Psy chose," maintains the position that these 
 factors are the sole causes of the defect. His argu- 
 ments are interesting and well worth following. 
 
 Denhardt attempts first of all to refute the current 
 theory that stammering is due to a failure of voice. 
 He declares that he has occasionally seen stammerers 
 that were unable to articulate isolated consonants 
 entirely unattached to vocal sound. ^ The phenome- 
 non that Denhardt describes would refute the "failure 
 of the voice" theory, but it is itself readily explained 
 by the theory adduced in this monograph. When a 
 person articulates the consonant h (for instance) in 
 the physiological alphabet, he produces the vowel 
 en souffle, or thinks it in auditory imagery and sup- 
 presses its oral production. If the auditory image 
 fails, the speaker may appear to stammer even on a 
 simple articulatory movement. 
 
 The auditory image attached to the physiological 
 consonant is not necessarily an image of the vowel- 
 sound that is associated with the consonant in the 
 common alphabet. It may be an image of the short 
 
 ^ That is, a consonant in the physiological alpkabet, in which b, 
 for instance, is a mere explosive movement of the lips, and not the 
 word be, as we know it in the ordinary alphabet. 
 
FEAR AND AUTO-SUGGESTION 293 
 
 u (u) that generally follows an explosive physiological 
 consonant. The failure of this image would account 
 for the stammering. If one were to stammer on a 
 simple movement of the lips that is kinaesthetically 
 initiated, he would stammer at the end of words, 
 and would stammer in smoking, etc. 
 
 Denhardt then attempts to refute the ''failure of 
 voice" theory by showing that stammering some- 
 times occurs when the speaker is making the transition 
 from the vowel to the consonant. He says : ^ 
 
 " On the other hand, there are not lacking stammerers that 
 experience difl&culty in making the transition with the speech- 
 organs from the position taken by the vowel to that required 
 for the consonant; consequently they repeat the vowel once 
 or twice in the form of a short ' af terstroke ' before they are able 
 to seize upon the consonant that completes the syllable. As 
 a result one hears something like Ka-ap and La-and, instead of 
 Kap and Land" 
 
 It is somewhat strange that Denhardt should 
 interpret these symptoms as betokening difficulty in 
 making the transition from the vowel to the consonant. 
 The symptoms are unquestionably due to respiratory 
 disturbances, one of the chief features of physical 
 stammering. The break in the vowel is due to a 
 sudden inhibition of the expiratory current: the 
 weakening of the air-column permits the glottis to 
 close, consequently there is a brief interruption in 
 
 * "Das Stottern eine Psychose," p. 28. 
 
294 THE PSYCHOLOGY OF STAMMERING 
 
 vocalization. The stoppage of the expiratory current 
 is due to a fluttering of the diaphragm, — one of the 
 natural concomitants of emotion. 
 
 There is another possible explanation for this 
 ''catch" in the vowel that Denhardt describes. The 
 stammerer may vocaKze from purely kinaesthetic cues, 
 but so long as he cannot recall the auditory image he is 
 unable to produce the vowel-color. It will be remem- 
 bered that this imperfect enunciation of the vowel 
 has been described by Hunt and other writers. (See 
 pp. 190-192.) It often takes the form of an inhibition 
 of the second element of a diphthong. As a rule, the 
 difficulty is directly due to defects of the auditory 
 imagery; but it is never due to the fact that the 
 stammerer experiences difficulty in articulating the 
 final consonant. ^ 
 
 These arguments of Denhardt are mentioned chiefly 
 because they are based upon facts that seem, if only 
 superficially examined, to be at variance with the theory 
 advanced in this monograph. They are the only heter- 
 odox facts that have been encountered, and it has 
 seemed advisable to lose no time in disposing of them. 
 
 Denhardt refutes, more or less successfully, the 
 current theory that stammering is due to a failure of 
 voice. He then defends the theory that stammering 
 is induced solely by fear and auto-suggestion : 
 
 " If one asks the stammerer why he is unable to speak fluently, 
 hewillinmostcasesreceivethereply/ It is because of fear.' . . . 
 
FEAR AND AUTO-SUGGESTION 295 
 
 If one goes a step further and endeavors to assure himself of 
 the nature of this fear and its foundation, he will regularly 
 find that it is based upon the stammerer's belief that he is 
 unable to speak." ^ 
 
 "It is quite immaterial for the influence of the disturbing 
 belief whether or not it has any foundation in fact. But the 
 belief has with the stammerer no basis in reality, for under 
 certain circumstances he is able to speak with consummate 
 
 ease 
 
 " 2 
 
 "We have to deal with a delusion that has driven its roots 
 so deeply into the consciousness of the stammerer that even if 
 it should leave him — as it may for days, weeks, or months 
 together — it invariably returns ; frequently, too, with in- 
 creased intensity." ' 
 
 One of Denhardt's chief arguments is the existence 
 of analogous phobias. He cites the case of a flute- 
 player that experienced the same difficulty in playing 
 as he did in speaking: 
 
 "When he had to play a solo with orchestral accompani- 
 ment, he felt himself incapable of beginning at the proper in- 
 stant. For hours before, he was haunted by fear of the dreaded 
 moment ; and the fear increased as the time approached. In 
 his room he could perform without hesitation ; but in the con- 
 cert hall, a few hours later, this had become an impossibihty." * 
 
 "I have seen stammering in piano-playing on several 
 occasions," remarks the same writer. He then re- 
 counts the experience of a young lady : 
 
 * Loc. cit., p. 144. ' Loc. cit., p. 144. 
 
 * Loc. cit., p. 145. ^ Loc. cit., p. 178. 
 
296 THE PSYCHOLOGY OF STA^IMERING 
 
 ''The eye would explore hastily in advance of the hands, 
 and would discover difficulties that at once induced fear of 
 failure. The nearer she approached them, the greater became 
 her fear of the supposed obstacles ; and at the critical moment 
 the disturbing influence of the fear effectually prevented the 
 proper execution of the necessary movements." ^ 
 
 Denhardt then gives an account of a subject that 
 was unable to write if some one were watching over 
 his shoulder : 
 
 "Whenever an R had to be followed by a vowel, there arose 
 in his mind the thought that he could not freely execute the 
 necessary writing-movements. Like the stammerer, he per- 
 formed all kinds of superfluous and purposeless movements. 
 Finally he accomplished his task by separating the vowel from 
 the initial consonant by a long dash {R — abe) . When he 
 knew himself to be unobserved he experienced no difficulty 
 with any combination, not excluding Ra, Ro, etc." ^ 
 
 The author then cites two cases in which difficulty 
 in swallowing was due to delusional belief, — to a 
 loss of confidence in the ability of the physical organs 
 to perform their normal functions. He says of one 
 subject : 
 
 "Upon my own initiative I brought him to the belief that 
 he had incurred the difficulty as the result of excessive cigar- 
 ette smoking. Upon his relinquishing the cigarettes, the 
 trouble disappeared. ' Now comes the stammering. Although 
 I have not smoked a cigarette since the improvement in my 
 condition, I have only to recall my former troubles in order to 
 
 ^ Loc. cit., pp. 178-179. ^ Loc. cit.y p. 179. 
 
FEAR AND AUTO-SUGGESTION 297 
 
 induce difficulties in swallowing. I then incur a relapse for a 
 day."'i 
 
 "The next case is of a little different nature. A gentleman 
 was accustomed for several years to taking all liquids from a 
 spoon, believing himself to be unable to drink. In drinking 
 from the spoon, however, he executed aU the movements of 
 deglutition in a perfectly normal manner — proof that he had 
 lost nothing of this faculty with which he was merely afraid 
 to intrust himself. The use of the spoon was of value only in 
 so far as it exerted a favorable influence upon his imagination. 
 The effects of the delusion were counteracted by the confident 
 belief that the use of the spoon would remove difficulties that 
 might otherwise appear. One day, after a long and trying 
 march, and while tormented by thirst, he rapidly drank a glass 
 of beer without reflecting. As the result of this incident he re- 
 gained his lost confidence in the organs of deglutition ; and this 
 confidence did not thereafter desert him." ^ 
 
 Denhardt concludes the recital with an account of a 
 man that had lost confidence in his ability to use his 
 hands in the presence of other people. While using 
 a soup-spoon, for instance, his hands would tremble 
 so severely that he became practically powerless. 
 He was able to master this weakness only by beginning 
 the meal with a powerful stimulant. 
 
 These morbid fears or obsessions are common 
 enough in pathology, and cases similar to the fore- 
 going might be cited indefinitely. The abnormal 
 fears are known as phobias. Many of them have 
 been endowed with a special name. ErytJirophohia is 
 
 * Loc. cit., p. 180. 2 Iq(. f-ii^ p jgj 
 
298 THE PSYCHOLOGY OF STAMMERING 
 
 the morbid fear of blushing ; klithrophobia, or klaus- 
 trophobia, is the fear that seizes one when alone in a 
 room; agoraphobia is the fear of crossing open 
 thoroughfares. When the agoraphobic patient is 
 compelled to cross an open square or traverse a wide 
 thoroughfare or bridge, — 
 
 "There ensues, according to Westphal's characteristic 
 description, an inordinate fear — a veritable death-terror — 
 accompanied by general trembling, an oppression of the chest, 
 palpitation of the heart, and sensations of chills or of a warm 
 wave mounting to the head. One breaks into a perspiration, 
 and stands as though helplessly paralyzed. There is weakness 
 of the limbs, and often sparks dance before the eyes. There is 
 humming in the ears ; there is nausea and complete confusion." ^ 
 
 St. Phar refers to these morbid fears in the following 
 words : ^ 
 
 " Pathological fear makes its appearance in the most diverse 
 forms, and not merely as agoraphobia. One person cannot 
 travel by train, another cannot ride in an electric car, or in 
 any vehicle at all, without experiencing these conditions of 
 fear. One patient is attacked by this abnormal dread during 
 thunder-storms; another when he finds himself in the midst 
 of a crowd, or when he is in a theatre, a church, or in a room 
 above the ground floor, or in a tunnel. Others experience 
 terror when the weather is a little more than ordinarily warm or 
 cold. Abnormal fears are particularly likely to appear under 
 those circumstances in which normal persons experience nor- 
 mal fear, as in accidents, earthquakes, fire, flood, and danger of 
 any kind that induces emotional disturbances and threatens 
 
 1 Eulenburg, Die Woche, March 17, 1906. 2 "Angst," pp. 4-5. 
 
FEAR AND AUTO-SUGGESTION 299 
 
 life and property. In short, fear is extremely multifarious. 
 It can appear in connection with any conceivable circumstance ; 
 and it reappears usually under those circumstances that were 
 responsible for its origin. It varies with the same patient, 
 assuming sometimes a more malignant and sometimes a milder 
 form." 
 
 In these phobias two conditions must be differen- 
 tiated. There is the simple fear, as such; that is, 
 the mere emotional disturbance : and there is the emo- 
 tion accompanied by an obsession or delusional belief. 
 In the fear of thunder-storms, only the emotional dis- 
 turbance is present. In agoraphobia there is abnormal 
 fear and also the belief in one's inability to cross the 
 thoroughfare. When both the fear and the delusion 
 are present, they of course react upon each other. 
 
 The phobias are either due to some unfortunate 
 experience accompanied by intense emotion, or they 
 are simple atavisms. In the latter case they are 
 reverberations of racial experience; i.e. they are in- 
 stinctive fears. In either case the emotion is aroused 
 by association. When the fear is acquired, the associa- 
 tion is due to the experience of the individual. When 
 the fear is instinctive, the association is due to racial 
 experience. This matter will be discussed subse- 
 quently at greater length. 
 
 After this sKght amplification we return to the 
 subject of stammering as caused by phobia and delu- 
 sional belief. Denhardt cites the morbid fears already 
 mentioned ; then continues : 
 
300 THE PSYCHOLOGY OF STAMMERING 
 
 " Supported by the analogies mentioned, we can safely state 
 that no objection need be feared to the theory already pro- 
 mulgated, — that stammering is a psychosis having its origin 
 in some more or less casual incident in the history of the patient. 
 This psychosis is based upon a delusion, an absolutely un- 
 founded belief that there exists an impediment to the free use 
 of speech. This delusion wreaks havoc with the different in- 
 nervations requisite for oral speech. Neither the expression 
 'fear' (Schranck) nor the term 'doubt' (Wyneken) is applicable 
 to this delusion, for when the delusion arises there is not doubt, 
 but subjective certainty ; and this certainty is not always ac- 
 companied by such feeHngs of malaise {Unlustgefuhle) as 
 would justify one in speaking of 'lalophobia' or 'speech-fear.' 
 These feelings of malaise are secondary, being induced by the 
 delusion, — which naturally enough gives rise to painful ex- 
 periences. One might regard stammering as one of the mani- 
 fold forms of hypochondria if the symptoms of the latter affection 
 were delusions concerning bodily disabilities, rather than 'fear 
 and anxiety for the body itself.'" ^ 
 
 The chief flaw in Denhardt's theory is that it does 
 not account for the inception of the speech-disturb- 
 ance. Denhardt imagines that stammering begins 
 by some sort of accident — an accidental stumbKng 
 in speech — and that introspection then confirms the 
 defect. (This same introspection and fear is made 
 to account for stammering when it is induced by 
 imitation and association.) The initial trouble 
 having arisen, the development of the malady 
 is easily explained : 
 
 ^ Loc. cit., pp. 181-182. 
 
FEAR AND AUTO-SUGGESTION 301 
 
 " Should the revived memory-picture possess sufficient clear- 
 ness and intensity to awaken feelings of anxiety and fear, and 
 should its fatal influence not be neutralized by reason or by an 
 unwavering faith in one's own faculties, then there steps in for 
 a second time bewilderment and delay to wreak havoc with 
 the movements that should give oral expression to thought. 
 The incident will be repeated, and with every repetition the dis- 
 turbing influences find an easier victory. The anxiety rising 
 from the recollection has shown itself to be well founded. Any 
 dubiety as to its foundation, which might at first have appeared, 
 is silenced by the seemingly incontrovertible evidence of fact. 
 Forthwith there disappears anxiety — care lest there should 
 recur those unhappy disturbances with which the malady be- 
 gan — and in its stead there prevails the subjective certainty 
 that the stammerer no longer has unimpeded use of speech. 
 Thus there is established the delusional belief that any attempt 
 to speak is frustrated by an actual impediment; though this 
 impediment has in truth no existence outside the imagination 
 of the now fully developed stammerer. This belief, with the 
 concomitant feelings of malaise (at times weaker and at times 
 stronger) is thenceforth the invariable cause of stammering." ^ 
 
 The delusional belief, according to the author, 
 assumes all kinds of illogical forms : 
 
 "For instance, some believe that they can speak better 
 during warm than during cold weather ; while others hold the 
 opposite view. In a way, both are right, for it cannot be 
 denied that whenever the conviction of this relation has become 
 seated in the mind of the stammerer, the circumstances will to 
 an extent accommodate themselves to the belief. Whoever 
 looks for the mitigation of his trouble in warmer weather will, 
 with the advent of such weather, in reality feel freer and more 
 
 ^ Loc. cit.y p. 147. 
 
302 THE PSYCHOLOGY OF STAMMERING 
 
 resolute, and will consequently stammer less. This result is 
 not to be attributed to the weather as such, but solely to the 
 stammerer's belief that the weather confers upon him a power 
 that he did not formerly possess." ^ 
 
 According to our author, a superstition prevails 
 that the intensity of the stammerer's impediment is 
 in some way correlated with the different phases of 
 the moon. The waning moon is supposed to mitigate 
 the impediment, and the crescent moon to aggravate 
 it. This belief influences the stammering: 
 
 "He that firmly believes in this lunar influence will find his 
 observations to some extent in accord with his theory ; but that 
 the moon is not accountable for the correlation is clearly shown 
 by the following incident. During the course of a conversation 
 a stammerer once informed me of this relation between the 
 severity of speech-disorders and the phases of the moon. I at 
 once insisted that there must be some mistake: he had the 
 relations reversed. And in truth this same gentleman aston- 
 ished me soon after with the information that I was right, and 
 that the waning moon was accompanied by an enhancement of 
 the impediment. The belief aroused by my positive assertion 
 was sufficiently powerful to influence the mind of the stammerer 
 in the direction suggested, so that he was able to discover vari- 
 ations in his own impediment corresponding to the changing 
 phases of the moon." ^ 
 
 Denhardt expresses a cogent truth in the theory 
 that stammering is due to fear and auto-suggestion. 
 The theory, however, expresses but a partial truth, 
 for fear and auto-suggestion merely aggravate the 
 
 1 Loc. cit., p. 86. ' Loc. cit., p. 87. 
 
FEAR AND AUTO-SUGGESTION 303 
 
 impediment — they do not cause it. They are them- 
 selves the efects of the disorder, and later they react 
 upon it as mediate causes. The immediate cause, as 
 we have seen, is usually transient auditory amnesia. 
 Denhardt himself regards the fear as an indirect rather 
 than a direct cause. The condition directly respon- 
 sible for the stammering he considers to be indecision, 
 or a wavering of will, this being caused in its turn by 
 the stammerer's lack of confidence in his own ability 
 to control the speech-organs. Denhardt says of this 
 vacillation of the will : 
 
 "An examination of the mental processes during stammering 
 shows that the disturbance takes the form of a struggle be- 
 tween two opposing forces, — the will, which endeavors to 
 translate the thought into spoken words, and the belief in one's 
 inability to accomplish what is intended. The former impels 
 forward, and the latter backward : the will to speak initiates 
 a movement, but in the same instant fear obstructs it. All 
 the characteristic phenomena of stammering emanate from this 
 conflict and from the visible efforts of the stammerer to pro- 
 cure the victory for the former at aU costs. In the end, the will 
 to speak invariably prevails, and compels the enunciation of 
 the word that was at first checked or impeded by the stam- 
 merer's fatal belief in his own disability. Often this conquest 
 is made only after continued struggle and bewildering effort." ^ 
 
 This indecision and constant checking of the fiat 
 has been mentioned in the preceding chapter. It is 
 an immediate cause of stammering, but it is itself a 
 
 ^ Loc. cit., pp. 176-177. 
 
304 THE PSYCHOLOGY OF STAMMERING 
 
 secondary manifestation. There would be no waver- 
 ing of the will if an impediment to speech did not 
 first exist. 
 
 One of the chief faults in Denhardt's theory is that 
 it takes no account of the origin of speech-disturbances. 
 Denhardt carefully classifies the inducing causes of 
 stammering, giving them as mechanical causes (a fall 
 or a blow, for instance), mental shock, and illness; 
 but he does not show how these causes operate. After 
 the cause has appeared, the patient simply stammers. 
 However, Denhardt testifies to the aphasic nature of 
 stammering in the following paragraph :^ 
 
 "One of my patients, when five or six years old, experienced 
 an unlucky fall on the head, which was accompanied by much 
 loss of blood. As a consequence he remained speechless for a 
 year. After this interval the speech returned, but it was dis- 
 torted by severe stammering, which had not left the patient 
 in his thirty-first year." 
 
 By the recital of such incidents and by his classifi- 
 cation of the inducing causes of stammering, Den- 
 hardt may fairly be said to compass the refutation of 
 his own theory. 
 
 As already stated, the theory supposes that the 
 impediment develops accidentally, and that it is con- 
 firmed by the subject's fear of its recurrence and by 
 his morbid introspection. The most cogent argument 
 against this developmental theory is that 87 per cent 
 
 1 Loc. cit., p. 104. 
 
FEAR AND AUTO-SUGGESTION 305 
 
 of stammerers are, as children, already subject to 
 the impediment before they enter school. This 
 means that the impediment develops before the age 
 of five or six. At this age the child is not addicted to 
 reflective self-analysis. He is not an introspectionist ; 
 he is an animal leading a sensory-motor Hfe. The 
 child does not reflect upon his own idiosyncrasies ; 
 and at an early age his peculiarities of speech pass 
 unnoticed. Certainly the child is not capable of 
 morbid self-analysis such as induces phobia. The 
 child stammers because of auditory amnesia. The 
 morbid fear develops later in hfe. 
 
 Denhardt endeavors to anticipate these objections. 
 He asserts that the child's reflections are all the more 
 deleterious because they are unreasoning, and because 
 the fear is based upon ignorance. His chief difiiculty, 
 though, is to show that the fear exists. In endeavor- 
 ing to establish the latter fact he unfortunately argues 
 by analogy. 
 
 *'One gives a little child a sour apple [he says]. After the 
 child has bitten it and experienced the unpleasant taste, he 
 lets the apple fall or throws it away. Let one repeat the ex- 
 periment after some time, and he will see how the child turns 
 away with evident aversion and rejects the apple that is offered 
 him." 1 
 
 Manifestly there is no parallel between these two 
 cases ; and any conclusion that may be derived from 
 
 ^ Loc. cit., p. 153. 
 
3o6 THE PSYCHOLOGY OF STAMMERING 
 
 the one has no application whatever to the other. In 
 the case of the apple we are dealing with a simple 
 association between a visual and a gustatory impres- 
 sion. In the case of stammering we are deaHngwith 
 an association between speech-hesitancy and an 
 emotion that has not yet been shown to exist. The 
 argument presupposes the existence in order to ar- 
 rive at the association. But even if the naive child 
 were to experience emotion and chagrin when 
 stammering, he would not be likely to develop lalo- 
 phobia through a process of morbid introspection. 
 Denhardt attributes undue precocity to the child. 
 If the child could develop stammering through morbid 
 anxiety after some accidental hesitancy in speech, 
 then there would exist a far greater number of stam- 
 merers; for every child falters at an early age when 
 acquiring command of language, and every child is 
 therefore a potential stammerer. 
 
 It is evident that Denhardt's theory fails conspicu- 
 ously in two respects : it does not account for the origin 
 of the stammering that is supposed to give rise to the 
 psychosis or phobia, and it does not account for the 
 fact that stammering develops in the entirely naive 
 period of life. The fear and auto-suggestion develop 
 at a later period, and they exist thereafter as mediate 
 causes. But the potency of these causes cannot be 
 easily overestimated. Denhardt has not emphasized 
 these secondary causes unduly. He is in error merely 
 
FEAR AND AUTO-SUGGESTION 307 
 
 in supposing them to be the sole causes that exist. 
 His book shows an excellent attempt to throw aside 
 the futile theories of the elocutionists. It can safely 
 be said that the reader would be well repaid for a 
 perusal of this interesting work. 
 
 A great many writers hold to the theory expressed 
 by Denhardt, and several of them expressed the 
 theory before him. Wyneken states his opinion as 
 follows : ^ 
 
 "Were I to attempt an explanation of the case, I should say 
 that the will is more or less restrained — so far as its control 
 over the speech-muscles is concerned — and that this occurs 
 through fear. The stammerer is a speech-doubter. When 
 he attempts a difficult word, his will is partially lamed by doubt, 
 — which one can in a way regard as an independent will in- 
 imical to the true will. The muscles controlling respiration, 
 phonation, and articulation do not know — if I may so express 
 myself — which master to obey ; therefore they do not properly 
 perform their functions, and stammering naturally ensues. 
 It is just as though one were to attempt a leap, and find himself 
 seized with doubt at the very moment that he springs. He is 
 too late to prevent the leap, but does not jump with confidence, 
 and hence does not accomphsh what he intended." 
 
 Werner says of fear : ^ 
 
 "Why is it that the stutterer, when alone, has no trouble, 
 but the very moment some one enters his presence he becomes 
 helpless ? The answer comes with irresistible force, — be- 
 cause of fear," 
 
 ^"Ueber das Stottem und dessen Heilung," pp. 20-21. 
 2 Werner's Voice Magazine, Vol. XI, pp. 86-87. 
 
3o8 THE PSYCHOLOGY OF STAMMERING 
 
 According to Frank :^ 
 
 "Stammering is a fear-neurosis, which is caused in neurotic 
 children by fright during the earliest years of life." 
 
 Stekel says : ^ 
 
 "One of the severest forms of pathological fear is found in 
 stammering, — the fear of speech. Originally it is the fear of 
 betraying some secret during speech. Later the fear becomes 
 transferred to the act of speaking itself." 
 
 Stekel introduces the inevitable "sexuelle Aetio- 
 logie" of the Freud school. At present his theories 
 of causality need scarcely be discussed.^ So far as 
 they relate to stammering they are sufficiently ridic- 
 ulous to carry their own refutation. 
 
 We shall now consider how these secondary causes, 
 fear and auto-suggestion, come to effect disturbances 
 in speech. We shall consider first the influence of 
 fear unattended by auto-suggestion, or belief in one's 
 own disabilities ; and then the effect of auto-suggestion 
 itself so far as it can be studied as an isolated factor. 
 Auto-suggestion, however, when it is a suggestion of 
 failure, is rarely unaccompanied by fear. 
 
 i"Die Psychanalyse," p. 15. 
 
 2 "Nervose Angstzustande und ihre Behandlung," p. 231. 
 
 3 The theories of the psychoanalytic school are discussed at some 
 length in Vol. II, Chap. VIL 
 
FEAR AND AUTO-SUGGESTION 309 
 
 The Direct Effects of Fear 
 
 Fear operates by paralyzing the musculature. It 
 inhibits even the grosser muscular movements. Many 
 persons cannot walk naturally upon a platform when 
 they know themselves to be the target for a battery 
 of eyes. Self-consciousness and fear deprive them 
 of muscular control, and there exists a condition 
 similar to agoraphobia. Westphal's description of 
 the patient suffering from agoraphobia (p. 298) is 
 merely the description of a person seized with extreme 
 fear. The person's helplessness is due to the fact 
 that he is mentally transfixed. 
 
 "People are frequently run over by carriages, cars, or trains 
 on account of the sudden great fright caused. The one idea 
 of danger reverberates in the mind like a sudden powerful clap 
 of thunder, confusing and stunning all other ideas ; the mind is 
 brought into a contracted cataleptic condition, and the field of 
 consciousness is narrowed down to that one idea, to a single 
 point." 1 
 
 Animals are often thrown by fright into a cataleptic 
 condition. This may occur also with human beings. 
 The cataleptic condition is physical, but it is accom- 
 panied by a condition of "mental catalepsy," as Sidis 
 figuratively expresses it. Denhardt records the case 
 of a boy that would frequently faint when his stam- 
 mering became severe. The fainting may not have 
 
 ^ Sidis, "The Psychology of Suggestion," p. 60. 
 
3IO THE PSYCHOLOGY OF STAMMERING 
 
 been wholly due to fear, but there can be no doubt 
 
 that it was due in large part to this cause. 
 
 Fear exerts its greatest influence upon the accessory 
 muscles. The articulative organs or fingers may be 
 rendered powerless when the larger muscles of the 
 body are practically unaffected. Fear causes one to 
 falter while playing the piano, and it interferes with 
 articulation in speech. The most fluent speakers 
 may be rendered impotent by stage-fright. 
 
 Fear induces cerebral congestion, and it is prob- 
 ably this condition that inhibits muscular control. 
 It will be remembered that Mosso's experiments 
 showed that there was a far greater flow of blood to 
 the brain during fear than during ordinary mental 
 activity : 
 
 "The brain-pulse became six or seven times greater than 
 before; the blood-vessels expanded, and the brain swelled 
 and beat with such vigor that my colleagues stared with aston- 
 ishment at the photogram of the tracings." ^ 
 
 Mosso relates an interesting incident apropos of 
 the afflux of blood to the brain, and the conse- 
 quent shrinkage of the body, during fear. A friend 
 informed him that upon the occasion of a sudden 
 fright a ring once dropped from his finger, — though 
 this ring ordinarily fitted so closely that considerable 
 effort was required to remove it. The incident shows 
 that fear must be accompanied by a prodigious flow 
 i"DieFurcht,"p. 73. 
 
FEAR AND AUTO-SUGGESTION 311 
 
 of blood to the brain. During fright this afflux of 
 blood to the brain is often so great that it causes 
 death through rupture of the cerebral vessels. 
 
 Cerebral hyperaemia probably effects an obfuscation 
 of the mental imagery. This subjective condition 
 would account for the exacerbration of stammer- 
 ing during fear, and for speechlessness during stage- 
 fright. The direct cause is amnesia; the inducing 
 cause is fear. It is not surprising that fear should 
 induce transitory disabiHties in speech, for fear is 
 one of the most proHfic causes of permanent stam- 
 mering and is one of the causes of aphasia. The 
 more intense emotion induces permanent stammer- 
 ing or aphasia probably through rupture or exces- 
 sive distension of the finer cortical vessels. The 
 weaker emotion may induce temporary stammering 
 through cerebral hyperaemia that leaves no injury to 
 the brain. 
 
 Fear seems to be particularly inimical to the audi- 
 tory imagery, — or perhaps it is that the obscuration 
 of the auditory imagery manifests itself in more 
 direct form. Persons affile ted with stage-fright often 
 stutter and articulate without producing a word. It 
 seems as though they are able to recall the grosser 
 articulative movements requisite for the enunciation 
 of the words, but unable to recaU the auditory images 
 necessary for their completion. In the stammerer, 
 the auditory imagery is more readily affected than 
 
312 THE PSYCHOLOGY OF STAMMERING 
 
 imagery of other forms. The auditory images are, 
 as it were, more readily extinguishable. It is, of 
 course, this vuhierability of the acoustic imagery that 
 makes the person a stammerer. 
 
 Pure fear — even when it is not speech-fear — is 
 likely to produce mental chaos or bewilderment, and 
 thus to interfere with the execution of speech. 
 ^'Presence of mind" under conditions of emotional 
 
 Fio. 7. — " Ordinary, quiet breathing ; i, inspiration ; e, expiration " 
 (after David Greene). 
 
 excitement is a rather rare attribute. "Absence of 
 mind," or chaos of mind, is the more common con- 
 dition. 
 
 Fear may aggravate physical stammering by in- 
 ducing respiratory disturbances. The disturbances 
 usually take the form of a ''fluttering" of the dia- 
 phragm. That the irregular action of the diaphragm 
 is due to emotion rather than to voluntary physical 
 stammering is shown by the fact that it is present 
 before the stammerer begins to speak. Often it com- 
 mences as soon as the stammerer is addressed. In- 
 trospection Hkewise discloses the fact that the abnor- 
 mal respiration is due to fear or excitement. The 
 
FEAR AND AUTO-SUGGESTION 313 
 
 condition is often induced by the mere thought of 
 speaking, when no occasion for speech actually exists. 
 Many writers have investigated these respiratory 
 disturbances with the pneumograph. Liebmann says 
 on the matter : ^ 
 
 Fig. 8. — "Irregular breathing caused by mental agitation while being 
 asked a question" (after David Greene). 
 
 "Gutzmann and I have studied the stammerer's abnormal 
 respiration by means of Marey's pneumograph. We ascertained 
 that the respiration of most patients becomes irregular just 
 before speech begins, and that all kinds of abnormal inspiratory 
 and expiratory movements occur during speech itself. During 
 normal speech there occurs a short, deep inspiration, followed 
 by a long and gradual expiration." ^ 
 
 Figures 7 and 8 show the respiratory curves obtained 
 by another investigator.^ The irregularities in the 
 second curve are caused by emotion. It is evident 
 
 ^ "Vorlesungen iiber Sprachstorungen," i. Heft, p. 7. 
 
 2 See also Gutzmann und Liebmann, "Pneumographische Unter- 
 suchungen iiber die Atmung derStotternden." (Wien. Med. BL, 1895.) 
 
 ^ David Greene, "The Preponderance of Male Stammerers over 
 Females." (New York Medical Journal, April 13, 1901.) 
 
314 THE PSYCHOLOGY OF STAMMERING 
 
 that such abnormahties of respiration as those recorded 
 must inevitably reveal themselves in speech. 
 
 AUTO-SUGGESTION 
 
 We shall now study the direct effects of suggestion, 
 bearing in mind the fact that fear is usually present 
 as a compHcating factor, and that pure auto-sugges- 
 tion rarely acts alone. 
 
 Stammering is sometimes induced by external 
 suggestion. It seems probable that fear is absent in 
 such cases. In the following words Sidis describes 
 the manner in which he induced stammering and 
 partial agraphia in one of his subjects : ^ 
 
 "I then tried on Mr. W. another experiment. 'Pronounce 
 "Boston."' — 'Boston,' and he said it easily enough. 'And 
 now again.' I stretched out my hand and made it perfectly 
 rigid. ' P-p-p-p-oston ! ' he ejaculated with great difficulty. 
 'Again.' I made my hand stiff er, and pointed it almost directly 
 in his face. No sound. 'Don't look at me,' he said at last, 
 'and I shall be able to say it.' 
 
 "'Well, then,' I said, 'try the following sentence: "Peter 
 Piper picked a peck of pickled peppers." ' He began to say 
 it, but when he came to ' peck of ' I raised my hand and stiffened 
 it. ' P-p-pe-ec-k ' came from his lips ; he began to stammer and 
 could not continue. 
 
 "'Well, then,' I said, 'let me see if you are able to pro- 
 nounce your own name.' He pronounced it. 'Try again.' 
 I stiffened my hand and again the same result — he was unable 
 to pronoimce his own name. . . . 
 
 *"The Psychology of Suggestion," pp. i8i ff. 
 
FEAR AND AUTO-SUGGESTION 315 
 
 "'Just try to write your name,' I said. He wrote it. 
 'Again.' He wrote it once more. I asked him to write slowly ; 
 meanwhile I raised my hand, stiffened it, kept it before his 
 very eyes. The results were now extremely interesting. His 
 hand became cataleptic ; he could not manage it. In a loud 
 voice he began to give suggestions to himself. '7 am able to 
 write my name ; I can write my name ; I will and shall write 
 it ; yes, I can ; I can write my name ; ' etc. Each time as he 
 caught sight of my raised hand and listened to the torrent of 
 suggestions I poured forth his hand became slightly cataleptic 
 and the letters became broken, but each time he repeated his 
 suggestions the hand went on writing. . . . [Finally] my sug- 
 gestions were completely disregarded." 
 
 Stammering and agraphia were produced in this case 
 by the inhibition of muscular control. The sight of the 
 stiffened hand aroused in the subject mental feehngs of 
 stiffness in his own muscles, and these kinaesthetic im- 
 ages were expressed in muscular contraction. There 
 probably resulted also an inhibition of the fiat, due to 
 the subject's behef in his inabihty to speak or write. 
 
 ^w/o-suggestion is undoubtedly the direct cause of 
 stammering m some cases. ^ It is the cause of stam- 
 mering when the subject has difficulty with only 
 one particular word but never with its homonyms or 
 derivatives. Thus the subject may stammer on 
 petroleum but not on petroleuse,'^ on two, but not on 
 
 1 A number of writers have attributed stammering to auto-sug- 
 gestion. See Moll, "Hypnotism"; Quackenbos, "Hypnotism in 
 Mental and Moral Culture," etc. 
 
 2 See Denhardt, "Das Stottern eine Psychose," p. 147. 
 
3i6 THE PSYCHOLOGY OF STAMMERING 
 
 too or to. In such cases, stammering is directly in- 
 duced by auto-suggestion ; but in the ordinary case of 
 stammering — i.e. in amnesic stammering — auto- 
 suggestion is operative only as a contributory or 
 secondary cause. 
 
 Auto-suggestion acts ordinarily by inhibiting voli- 
 tion. The subject firmly beHeves in his inabiHty to per- 
 form a certain act, and therefore hesitates to attempt it. 
 Even after beginning, he is repeatedly deterred by 
 the conviction of his own impotence. As we have 
 already seen, Denhardt and Wyneken regard this 
 wavering of the will as the direct cause of stammering. 
 It is one of the principal causes. It renders the 
 stammerer constantly irresolute, and frequently pre- 
 vents him from observing a direct and progressive 
 procedure in the expression of even the simplest 
 thought. This fact is fittingly illustrated by a couple 
 of incidents that Denhardt records : 
 
 A young man wished to purchase a theatre-ticket 
 for the parquet, but fearing that he might stammer, 
 he began by asking for ''ein Billet zum ersten Rang." 
 Then a moment later he feigned a change of mind, 
 and asked in the most casual manner for ''ein Parkett- 
 biUet."! 
 
 Denhardt then relates an incident in his own 
 experience : ^ 
 
 1 "Das Stottern eine Psychose," p. 46. 
 
 2 Loc. cit., pp. 46-47. 
 
FEAR AND AUTO-SUGGESTION 317 
 
 "This reminds me of a strategem that often rendered me 
 good service, when, as a boy, I had to purchase cigars for my 
 father. Upon entering the shop I walked to the open case, 
 which contained an assortment of cigars of which I knew the 
 prices perfectly weU. In affected ignorance I pointed to and 
 inquired about a particular cigar that I had no intention of 
 buying. I repeated these tactics with one or two others till 
 I thought the propitious moment had arrived ; then I requested 
 the shop-girl to give me the particular brand of cigars that I 
 had been commissioned to buy." 
 
 Most stammerers could cite incidents of a like 
 nature in their own experience. These facts illus- 
 trate the point already made, — that the stammerer 
 often fails to observe a direct and progressive manner 
 of thought. There is endless vacillation of the will, 
 and the verbal image that should instigate oral 
 speech is constantly inhibited. The inhibition occurs, 
 too, after the stammerer has begun to speak, and in 
 this case it is directly responsible for the stammering. 
 
 Auto-suggestion can operate in another way. 
 When the stammerer expects to encounter difficulty 
 with a particular word, he attends to his stammering 
 rather than to his speech. Mental images of the ex- 
 pected stammering — labial effort, contraction of the 
 lingual muscles, etc. — then get to the focus of atten- 
 tion, and displace the normal verbal images. These 
 imnatural mental images, of course, express them- 
 selves in muscular movements, and stammering ensues. 
 
 Auto-suggestion thus induces stammering through 
 
3i8 THE PSYCHOLOGY OF STAMMERING 
 
 the inhibition or the displacement of the normal 
 verbal image. It is probable that inhibition is itself 
 brought about only by the diversion of attention to 
 an obsessing image. The subject offers a rich field 
 for investigation. 
 
 Some stammerers find that they are able to speak 
 when they feel ''compelled" to do so by the very 
 urgency of a situation. There are stammerers, for 
 instance, that speak well in public. Martin Tupper 
 never stammered when reading or reciting. Charles 
 Kingsley spoke well from the pulpit, but stammered 
 badly in conversation. The writer knows several 
 ministers that have this experience. One stammerer 
 of the writer's acquaintance is a successful amateur 
 actor; another is a talented orator and debater. A 
 probable reason for the stammerer's fluency imder 
 coercive conditions is that he is seized with a deter- 
 mination to give unimpeded expression to thought, 
 and that he therefore ceases to vacillate, and redinte- 
 grates the verbal images in a consecutive and orderly 
 manner. It is doubtful whether this is the sole 
 reason for the stammerer's fluency. It is probable 
 that the very urgency of the situation really assists 
 the stammerer in overcoming his amnesia. This 
 phenomenon would not be surprising, for we find 
 that aphasic patients often break the bonds of silence 
 under the pressure of intense emotion. Unfortu- 
 
FEAR AND AUTO-SUGGESTION 319 
 
 nately, the stammerer's speech often suffers in the 
 reaction, and a complete collapse follows the brief 
 subjugation of the impediment. 
 
 Stammerers that are able to suppress the impedi- 
 ment by sheer force of will are certainly in the minority. 
 The majority of stammerers experience fear that is 
 proportionate to the exigency of the circumstances, 
 and stammering is proportionate to tne fear. This 
 is a somewhat perverse condition of affairs, but it is 
 nevertheless the condition that usually prevails. 
 
 Denhardt believes that the stammerer's fluency 
 or difficulty in speech under particular circumstances 
 is due entirely to the memory of the initial success 
 or failure. If the stammerer succeeds the first time 
 he talks from a platform, he is confident thereafter, 
 and consequently speaks with fluency. If he stam- 
 mers the first time, he fears further attempt ; hence 
 stammers on future occasions: 
 
 "The memory of success or failure has the greatest sig- 
 nificance in the life of the stammerer. Should he by chance 
 speak well at the beginning of the day, then the outlook for 
 the rest of the day is more favorable : the converse also is 
 true. If he stammers first on a p, he acquires a special fear 
 of this letter, and consequently has trouble with words that 
 begin with it. The effect of memory varies with the circum- 
 stances, and it is extraordinarily diverse in duration. The 
 effect may endure for hours, weeks, or months." ^ 
 
 1 Denhardt, "Das Stottern eine Psychose," p. 84. 
 
320 THE PSYCHOLOGY OF STAMMERING 
 
 Emotional Association 
 
 The effect of the initial success or failure is 
 explained by emotional association. The fear or 
 assurance that originally accompanied a particular 
 circumstance is recalled by the recurrence of the 
 circumstance itself. The emotion then impedes or 
 faciHtates speech. This emotional association ex- 
 plains the idiosyncratic differences among stam- 
 merers themselves. 
 
 Particular words, as well as particular circum- 
 stances, acquire associations that render them effective 
 mischief-makers. The word seems to acquire the 
 emotion of fear as one of the elements of the con- 
 cept. As soon as the word appears on the horizon 
 of consciousness, there occurs a deluge of emotion 
 that buries all verbal imagery by its very intensity. 
 Mental chaos and loss of muscular control then 
 render the stammerer impotent. 
 
 The fear of these particular words often takes the 
 form of a veritable phobia. The stammerer picks 
 out difficult words more or less consciously in silent 
 thought, and even frames his own verbal thoughts 
 to avoid them. He selects difficult words as he 
 listens to the conversation of another person, and 
 looks for his enemies while reading. This is lalo- 
 phobia in an unmitigated form. 
 
 Emotional association is one of the most potent 
 
FEAR AND AUTO-SUGGESTION 321 
 
 influences in human life. An emotion that has ac- 
 companied a particular circumstance tends in a 
 remarkable way to be aroused by the recurrence of 
 the circumstance itself.^ The emotion seems to be 
 not merely aroused by the mental image or impres- 
 sion, but seems rather to become an integral part 
 of the concept.^ One surveys the scene of a former 
 accident with horror. One regards some detestable 
 creature with loathing, hatred, or fear. One regards 
 a friend with affection or esteem. The particular 
 circumstances that engendered these feehngs may be 
 entirely forgotten. The emotion simply attaches 
 itself to the object and cHngs to it thereafter irrespec- 
 tive of the presence or absence of intelHgent cognitive 
 memory. 
 
 Of all emotions, fear forms the most powerful asso- 
 ciations. The reason for this is evident. During 
 the early history of the race, a strong emotional as- 
 sociation of this nature would be a biological neces- 
 sity. The individual possessed of strong associa- 
 tions of fear would be Hkely to survive. On the 
 other hand, the individual that was devoid of this 
 
 ^ The converse of this principle is expressed in the proposition 
 that our thoughts are consistent with our moods. 
 
 2 Many authorities hold that there is no "affective memory"; 
 i.e. that there are no mental images of emotional experiences. They 
 believe that the emotions are revived in actuality and not in memory. 
 But even under these cirsumstances one could regard the awakened 
 emotion as one of the elements of the concept. 
 
322 THE PSYCHOLOGY OF STAMMERING 
 
 emotional association would soon be eliminated. 
 Fear has thus been self -perpetuating ; and strong 
 fear-associations have come to be a racial heritage. 
 Many of these associations are ready-made : the fear 
 is instinctive, and occurs anterior to all experience. 
 ''Secondary," or acquired, fears are estabhshed by 
 the experience of the individual; but they may 
 remain as quasi-instinctive fears after the incidents 
 that occasioned them are forgotten. 
 
 "Cases of strange and insunnountable fear or antipathy 
 have been noticed in some celebrated men: Scaliger was 
 seized with nervous trembling at the sight of the water-cress, 
 Bacon fainted during eclipses, Bayle at the sound of running 
 water, James I at the sight of a naked sword." ^ 
 
 Ribot supposes these fears to be due to the for- 
 gotten experiences of early childhood. Such instances 
 demonstrate the persistence of fear-associations. 
 Many of the phobias cited in the earher part of the 
 chapter are manifestly due to individual experience, 
 and often to experiences that have been totally 
 forgotten. 
 
 Instinctive emotions, due to racial experience, are 
 common in both human beings and the lower animals. 
 The chick fears the hawk, though it has had no 
 encounter with the depredator. Most animals show 
 instinctive fear of their natural enemies. Gratilot 
 gave a very young puppy a fragment of wolf's skin 
 
 ^ Ribot, "The Psychology of the Emotions," p. 216. 
 
FEAR AND AUTO-SUGGESTION 323 
 
 so worn that it resembled parchment. When the 
 animal smelled it, he was seized with intense fear.^ 
 In this case fear was aroused by a simple olfactory 
 stimulus. Instinctive fears are forever outcropping 
 in the human being. We see racial reverberations 
 in the fear of the dark and of water, in tHe dread of 
 high places and of solitude, in the fear of reptiles, 
 insects, fur, etc. 
 
 "Children who have been carefully guarded from all ghost- 
 stories are nevertheless terrified and cry if led into a dark place, 
 especially if sounds are made there. Even an adult can easily 
 observe that an uncomfortable timidity steals over him in a 
 lonely wood at night, although he may have the fixed con- 
 viction that not the slightest danger is near." ^ 
 
 These instinctive fears, of course, vary greatly in 
 different persons. In a few persons, most of the 
 instinctive fears are present. In others, only the 
 more common and '^ natural" fears are in evidence. 
 All degrees of variation are found between the two 
 extremes. 
 
 Fear as an emotion and an instinct has practically 
 outhved its usefulness. (This is true, at least, of the 
 emotion in its intenser forms.) Fear has been an 
 important factor in the evolution of the race, but 
 civiUzed races have now reached a point of develop- 
 
 ^ Ribot, "The Psychology of the Emotions," p. 7. 
 2 Schneider, "Der Menschliche Wille," p. 224; quoted by James, 
 "Principles of Psychology," Vol. II, p. 418. 
 
324 THE PSYCHOLOGY OF STAMMERING 
 
 ment where instinctive fears and fear-associations 
 have Uttle function to perform. Fear has become 
 an execrable heritage, for in most cases its function 
 is perverted, and the emotion is aroused by an entirely 
 inappropriate stimulus. As an instinct, fear is almost 
 an atavism; as an emotion aroused by associational 
 bonds, it it usually a curse. Fear makes it impos- 
 sible for one to accomplish the very thing in which 
 he dreads to fail. 
 
 Ribot holds that any fear is pathological when it 
 becomes hurtful rather than useful. Fere's criterion 
 of the morbid is the undue intensity of the emotion, 
 its unreasonable prolongation, and insufhciency of 
 the cause. According to these tests, most instinc- 
 tive and acquired fears are pathological when the 
 emotion reaches any considerable degree. The stam- 
 merer's fear is imquestionably pathological. In this 
 case all criteria are superfluous. 
 
 So much for instinctive fears and fear- associations. 
 
 The Nature of Fear 
 
 We shall consider now the intrinsic nature of fear and 
 of emotion in general. Emotion is usually regarded 
 as a purely mental phenomenon — as something that 
 one feels actually within the mind. The emotion 
 is thought to be aroused by its appropriate ob- 
 ject, and the physical disturbances to be aroused 
 in their turn by the emotion. The James-Lange 
 
FEAR AND AUTO-SUGGESTION 325 
 
 theory/ a theory that is now widely accepted by 
 psychologists, exactly reverses this sequence. It sup- 
 poses that the physical disturbances occur reflexly when 
 the stimulus appears, and that the emotion is nothing 
 more nor less than the feehng of these phy^cal distur- 
 bances. That this is the more logical order of the 
 events should be evident from our previous discussion 
 of inherited instincts. An organism cannot inherit 
 knowledge : it is not aware, during its first experi- 
 ence, of the nature of the impending danger from 
 which it flees. When it flees, it mxcrely reacts to an 
 emotional stimulus. The presence of the emotion can 
 be explained only on the ground that it consists in 
 the feehng of reflex physical disturbances. James 
 explains his theory concerning the sensory nature of 
 emotion as follows : ^ 
 
 "Our natural way of thinking about these coarser emotions 
 is that the mental perception of some fact excites the mental 
 affection called the emotion, and that this latter state of mind 
 gives rise to the bodily expression. My theory, on the con- 
 trary, is that the bodily changes follow directly the perception of 
 the exciting fact, and that our feeling of the same changes as they 
 occur, IS the emotion. Common-sense says, we lose our fortune, 
 are sorry and weep ; we meet a bear, are frightened and run ; 
 we are insulted by a rival, are angry and strike. The hypotb- 
 
 ^ For a complete discussion of this theory see C. Lange, "Ueber 
 Gemiithsbewegungen," Leipzig, 1887; and James, "Principles of 
 Psychology," Chap. XXV. 
 
 2 "Principles of Psychology," Vol. II, pp. 449-450. 
 
326 THE PSYCHOLOGY OF STAMMERING 
 
 esis here to be defended says that this order of sequence is 
 incorrect, that the one mental state is not immediately induced 
 by the other, that the bodily manifestation must first be inter- 
 posed between, and that the more rational statement is that 
 we feel sorry because we cry, angry because we strike, afraid 
 because we tremble, and not that we cry, strike, or tremble, 
 because we are sorry, angry, or fearful, as the case may be. 
 Without the bodily states following on the perception, the latter 
 would be purely cognitive in form, pale, colorless, destitute of 
 emotional warmth. We might then see the bear, and judge 
 it best to run, receive the insult and deem it right to strike, 
 but we should not actually /^e/ afraid or angry." 
 
 That emotion is not a purely mental phenomenon 
 is evident from the fact that it is entirely independent 
 of cognition. Fear persists in spite of one's positive 
 belief in the non-existence of danger. Looking down 
 from the top of a monument, one trembles despite 
 the fact that he knows he cannot fall. He is behind 
 an iron raihng, and could not fall if he wished ; but 
 this knowledge does not inhibit the reflex visceral 
 changes, and consequently does not inhibit fear. 
 One trembles as a lion springs forward in his cage. 
 One knows perfectly well that there is no danger, 
 and may even feel ashamed at his own apparent 
 timidity; yet he cannot suppress the reaction or the 
 corporeal changes that give rise to fear. 
 
 The bodily changes occur reflexly, and they are 
 but little under the control of the will. For this 
 reason intelligent reflection has little effect upon the 
 
FEAR AND AUTO-SUGGESTION 327 
 
 feelings. The emotions of sorrow and anxiety that 
 one experiences in a theatre are not dispelled by the 
 thought that the fair maiden is paid so much a week 
 for being killed by the villain. One's syn^athy with 
 the maiden and indignation at the villain are none 
 the less sincere. But the emotions cannot be con- 
 trolled even when things more serious are at stake. 
 A surgeon would scarcely undertake to operate on a 
 near and dear relative, for he knows that his fear and 
 anxiety cannot be subdued, and that his emotions — 
 try as he may to suppress them — will render him 
 impotent at a time when Kfe and death depend upon 
 his self-control. 
 
 If an emotion were purely cognitive, there would 
 be no reason why it should ever cease. An insult 
 or a wrong is no less an insult or a wrong because it 
 was suffered a year ago. The loss of a friend is no 
 less a bereavement because it occurred in the past. 
 Yet such affairs of the past are usually viewed with 
 considerable sang-froid. The knowledge or cognition, 
 however, has not changed. The physical reactions 
 have merely worn themselves out.^ 
 
 Introspection shows that emotion is nothing more 
 than the feeling of changes proceeding within the body: 
 
 "If one notices the uncomfortable mood brought about by 
 ■ strained expectation, anxiety before a public address, vexa- 
 
 ' The intensity of the memory-images would have to be con- 
 sidered in a more thorough analysis of such cases. 
 
328 THE PSYCHOLOGY OF STAMMERING 
 
 tion at an unmerited affront, etc., one finds that the suffering 
 part of it concentrates itself principally in the chest, and that 
 it consists in a soreness, hardly to be called pain, felt in the middle 
 of the breast and due to an unpleasant resistance which is offered 
 to the movements of inspiration and sets a Umit to their extent. 
 The insufficiency of the diaphragm is obtruded upon conscious- 
 ness, and we try by the aid of the external voluntary chest 
 muscles to draw a deeper breath." ^ 
 
 These physical changes giving rise to emotion are 
 usually so numerous and subtle that, as James says, 
 ^'the entire organism may be called a soimding- 
 board, which every change of consciousness, however 
 slight, makes reverberate." The feeling of these 
 changes alone constitutes the emotion. If the feel- 
 ings are subtracted, no emotional coloring remains. 
 
 "What kind of an emotion of fear would be left if the feeling 
 neither of the quickened heart-beats nor of shallow breathing, 
 neither of the trembling lips nor of weakened limbs, neither of 
 goose-flesh nor of visceral stirrings were present, it is quite 
 impossible for me to think. Can one fancy the state of rage 
 and picture no ebullition in the chest, no flushing of the face, 
 no dilation of the nostrils, no clenching of the teeth, no impulse 
 to vigorous action, but in their stead limp muscles, calm breath- 
 ing, and a placid face ? " ^ 
 
 It is manifest that if the physical feehngs were 
 absent, the emotion would no longer exist. The 
 emotion of sorrow often has its nucleus in a "lump 
 
 * James, " Principles of Psychology," Vol. II, p. 445 (quoting Henle, 
 "Natural History of the Sigh"). 
 'James, loc. cit.y p. 452. 
 
FEAR AND AUTO-SUGGESTION 329 
 
 in the throat." A slight fear, as one slips on the stairs, 
 is often nothing more than a momentary ''chill" in 
 the small of the back. Cutaneous shivering often 
 constitutes the chief part of the emotiofi that one 
 feels when hstening to poetry or music. A spinal 
 chill occurs when one hstens to the grating of two 
 sharp steel edges. The chill is emotional in color- 
 ing; yet it is manifest that no emotion of a mental 
 nature is present. 
 
 The physical concomitants of emotion are often 
 very conspicuous. A severe fright may bleach the 
 hair, deprive one of consciousness, of sight, of speech, 
 or of the use of one or more of the limbs.^ A milder 
 fright will cure hiccups or drunkenness, — likewise 
 through the operation of corporeal changes. Blush- 
 ing may be ''so intense as to cause a rash afterward ; 
 and, in rare cases, it may amount almost to vesica- 
 tion." 2 
 
 Emotion is due not merely to the grosser physical 
 changes within the body; but also to chemical 
 changes in the tissues and to activity in the various 
 glands. These chemical changes, as well as the 
 grosser physical changes, can often be artificially 
 induced. Drugs may transmute the whole nature of 
 the psychical mood. The im.bibing of a Httle alcohol 
 
 * In all but the first case, through the mediation of cerebral changes. 
 2 G. Stanley Hall, ''A Study of Fears" {Amer. Jour, of Psych., 
 January, 1897). 
 
330 THE PSYCHOLOGY OF STAMMERING 
 
 will change one's entire outlook upon the world. 
 Imbibing to excess inhibits the outlook entirely. 
 Hashish produces exaltation, and ipecacuanha in- 
 duces depression or fear. 
 
 Bodily diseases affect the moods. A bad case of 
 dyspepsia is apt to be as uncomfortable for the im- 
 mediate associates of the patient as it is for the patient 
 himself. Diabetes is often accompanied by depres- 
 sion, and phthisis by joyful spirits. These emotions 
 or moods are physical in origin : they are due to 
 chemical changes within the system. Morbid emo- 
 tional conditions are often due to disease. Mel- 
 ancholy may result from a blow upon the head; 
 cheerfulness returns when an operation reheves an 
 abnormal pressure on the brain. 
 
 "In every asylum we find examples of absolutely unmotived 
 fear, anger, melancholy, or conceit ; and others of an equally 
 immotived apathy, which persists in spite of the best of out- 
 ward reasons why it should give way." ^ 
 
 The thyroid gland, situated at the base of the larynx, 
 is in some inscrutable way intimately connected with 
 the emotional Hfe of the human being. Diseases 
 of the thyroid gland are usually accompanied by 
 pronounced emotional disturbances. Of goitre, an 
 affection of this particular gland, Havelock Ellis 
 says : ^ 
 
 * James, loc. cit., p. 459. 
 
 2 "Man and Woman," 4th ed., p. 268. 
 
FEAR AND AUTO-SUGGESTION 331 
 
 "The appearance of the patient suffering from this disease 
 — the staring protruded eyes, the breathlessness and rapid 
 heart, etc. — suggests a person suffering from terror, and it is 
 remarkable that fright has often formed the starting point of 
 the disease." 
 
 Graves' disease is a somewhat similar disorder ; and 
 the patient suffering from it presents all the symptoms 
 of extreme terror. The following is Dr. Mackenzie's 
 description of the malady : ^ 
 
 "Fright, intense grief, and other profound emotional dis- 
 turbances have been recognized as causes of the pathological 
 condition, but I do not think that sufficient attention has been 
 paid to the very close connection between the chronic symptoms 
 of Graves' disease and the more immediate effects of terror. 
 The descriptions given by Darwin and Sir Charles Bell of the 
 condition of man in intense fear might almost have been written 
 in regard to one of the patients we have been considering. 
 The heart beats quickly and violently, so that it palpitates or 
 knocks against the ribs. There is trembling of all the muscles 
 of the body. The eyes start forward, and the uncovered and 
 protruding eyeballs are fixed on the object of terror. The 
 surface breaks out into a cold clammy sweat. The intestines 
 are affected. The skin is flushed over the face and neck down 
 to the clavicles. The hair stands erect. 'Of all emotions, 
 fear notoriously is the most apt to induce trembling.' The 
 symptoms of terror are common to man and the lower animals. 
 There are one or two of the minor symptoms of Graves' dis- 
 ease whose independent occurrence under the influence of 
 
 1 Lancet, September, 1890. (Quoted by Ellis, " Man and Woman," 
 4th ed., p. 269.) 
 
332 THE PSYCHOLOGY OF STAMMERING 
 
 emotion is well known. These are pigmentary changes in the 
 skin and hair, falling out of the hair, and epistaxis." 
 
 Patients suffering from dyspepsia often manifest 
 the same S3anptoms. The physical changes being 
 present, they experience the emotion of fear ; and this 
 fear is in no way different from the fear that would 
 be aroused by the perception of some fear-inducing 
 object. The following is a description of the purely 
 physical fear of the dyspeptic : 
 
 "All physicians who have been much engaged in general 
 practice have seen cases of dyspepsia in which constant low 
 spirits and occasional attacks of terror rendered the patient's 
 condition pitiable in the extreme. I have observed these cases 
 often and have watched them closely, and I have never seen 
 greater suffering of any kind than I have witnessed during these 
 attacks. . . . Thus, a man is suffering from what we caU 
 nervous dyspepsia. Some day, we will suppose in the middle of 
 the afternoon, without any warning or visible cause, one of these 
 attacks of terror comes on. The first thing the man feels is 
 great but vague discomfort. Then he notices that his heart 
 is beating much too violently. At the same time shocks or 
 flashes as of electrical discharges, so violent as to be almost 
 painful, pass one after another through his body and limbs. 
 Then in a few minutes he falls into a condition of the most in- 
 tense fear. He is not afraid of anything ; he is simply afraid. 
 His mind is perfectly clear. He looks for a cause of his wretched 
 condition, but sees none. Presently his terror is such that he 
 trembles violently and utters low moans; his body is damp 
 with perspiration; his mouth is perfectly dry; and at this 
 stage there are no tears in his eyes, though his suffering is in- 
 
FEAR AND AUTO-SUGGESTION 333 
 
 tense. When the climax of the attack is reached and passed, 
 there is a co{)ious flow of tears, or else a mental condition in 
 which the person weeps upon the least provocation. At this 
 stage a large quantity of pale urine is passed. Then the heart's 
 action becomes again normal, and the attack passes off." ^ 
 
 The existence of these purely physiological fears 
 supplies the last link in our chain of evidence. It 
 should now be clear that emotion is nothing more than 
 the feeling of bodily changes that occur in response to 
 specific stimuli. With the origin of these changes we 
 are not concerned. The reader that is interested in 
 the matter is referred to special works on the psy- 
 chology of the emotions.^ 
 
 In the next chapter we shall consider briefly the 
 possibility of controlling the physical reactions that 
 give rise to fear. 
 
 1 R. M. Bucke, "Man's Moral Nature," p. 97. (Quoted by James, 
 "Principles of Psychology," Vol. II, p. 460.) 
 
 2 Darwin, "The Origin of the Emotions"; Bain, "The Emotions 
 and the Will"; Ribot, "The Psychology of the Emotions"; James, 
 "The Principles of Psychology"; Spencer, "The Principles of Psy- 
 chology"; etc. 
 
CHAPTER X 
 
 COROLLARIES 
 
 In the foregoing chapters we have studied the causes 
 of stammering. In this chapter we have to consider 
 briefly in what measure these causes may be ob- 
 viated. The primary cause of stammering, it has 
 been shown, is transient auditory amnesia. The 
 secondary, or auxihary, causes are bewilderment; 
 perversion of the verbal imagery ; auto-suggestion giv- 
 ing rise to inhibition of the will ; and, finally, fear. 
 The use of physical effort in speech might be regarded 
 as another of the mediate causes of stammering; 
 but the physical stammering to which it gives rise is 
 really an extraneous symptom. It must be differen- 
 tiated from the abnormal speech that reflects the 
 verbal imagery, and must receive its special form of 
 treatment. 
 
 It is at once evident that the secondary causes of 
 stammering are themselves effects of the primary cause. 
 If the primary cause, auditory amnesia, could be 
 removed, the secondary causes, fear, wavering of the 
 will, etc., would quickly vanish. The removal of 
 the amnesia is, then, of chief importance. However, 
 
 334 
 
COROLLARIES 335 
 
 there can be little doubt that the secondary causes 
 are chiefly responsible for stammering in many cases. 
 When elocutionary methods effect a cure, as they do 
 in a few instances, there can be httle amnesia in- 
 volved. One must conclude that in such cases the 
 secondary causes of stammering (the efects of the pri- 
 mary disturbance) persist after the auditory amnesia 
 has disappeared. 
 p The stammerer must diagnose his own case, and 
 determine to what extent each of the several causes 
 conduces to the disturbance of his speech. If he 
 finds that little amnesia is present, he may be sure 
 that his defect of speech can be readily overcome. 
 
 We shall now consider the various secondary causes 
 of stammering, taking them in the order of conven- 
 ience. Afterward, we shall discuss the subject of 
 auditory amnesia, and the question of obviating it. 
 We begin with the discussion of fear. 
 
 Fear 
 
 Fear, we have seen, is nothing more than the feel- 
 ing of certain physical changes going on within the 
 body. If these bodily changes could be prevented, 
 the emotion would not arise. Unfortunately, most 
 of the bodily organs in which these changes occur 
 are not under the direct control of the will. One may 
 change the facial expression, relax the tightened 
 muscles, and alter the respiration; but one cannot 
 
336 THE PSYCHOLOGY OF STAMMERING 
 
 directly control the subtile activity of the internal 
 organs. Within certain limits, the internal changes 
 are subject to the influence of physical association; 
 but the changes cannot be directly inhibited, hence 
 the emotion cannot be directly controlled. 
 
 James advocates the practice of simulating an 
 opposite emotion. The argument is that the volun- 
 tary expression of the emotion induces, to some extent, 
 the involuntary physical changes, and that the volun- 
 tary and involuntary changes are then felt as a form 
 of the emotion simulated. It is evident that the un- 
 desirable emotion must be neutralized if the assumed 
 emotion is felt even to a sHght degree, for the two 
 contrary emotions cannot coexist. James's remarks 
 on the subject are as follows : ^ 
 
 "Refuse to express a passion, and it dies. Count ten before 
 venting your anger, and its occasion seems ridiculous. Whist- 
 ling to keep up courage is no mere figure of speech. On the 
 other hand, sit all day in a moping posture, sigh, and reply to 
 everything with a dismal voice, and your melancholy lingers. 
 There is no more valuable precept in moral education than this, 
 as all who have experience know : if we wish to conquer unde- 
 sirable emotional tendencies in ourselves, we must assiduously, 
 and in the first instance cold-bloodedly, go through the out- 
 ward movements of those contrary dispositions which we prefer 
 to cultivate. The reward of persistence will infallibly come, 
 in the fading out of the sullenness or depression, and the advent 
 of real cheerfulness and kindliness in their stead. Smooth the 
 
 * "Principles of Psychology," Vol. II, p. 463. 
 
COROLLARIES 337 
 
 brow, brighten the eye, contract the dorsal rather than the 
 ventral aspect of the frame, and speak in a major key, pass the 
 genial compliment, and your heart must be frigid indeed if it 
 does not gradually thaw ! " 
 
 Emotions can sometimes be counteracted in a meas- 
 ure by deliberate analysis of them. Fear may lose 
 its prestige when it is viewed as an agglomeration 
 of bodily sensations. But the efhcacy of self-analysis 
 is determined entirely by the temperament. With 
 some subjects it may be deleterious rather than bene- 
 ficial. 
 
 The stammerer must, as far as possible, annihilate 
 fear-associations — or, better, prevent their forming — 
 by dehberately ignoring failures and unpleasant in- 
 cidents. From the very nature of the human mind, 
 the act of disregarding such incidents must tend, by 
 weakening the associations, to exclude recollection of 
 them. Brooding over failures has the opposite effect. 
 It tends to imprint the incidents more deeply on the 
 mind, and to endow them with an emotional color- 
 ing that later exerts a pernicious influence. 
 
 The nature of the emotional Hfe is largely deter- 
 mined by the physical condition. A person in ex- 
 cellent health is little subject to baseless fears. On 
 the other hand, the person that is ''run down" and 
 ''unstrung" is Hable to all sorts of nervous and 
 emotional disturbances. Lowered vitaHty affects 
 the stammerer in a number of ways. It not only 
 
338 THE PSYCHOLOGY OF STAMMERING 
 
 enhances his fear, but it aggravates the amnesia. The 
 amnesia and fear then aggravate each other. 
 
 Knowledge is the greatest counteractive of fear. 
 ''By long consent, knowledge is power; still more 
 emphatically and specially, knowledge is composure" 
 (Bain). When the stammerer knows the cause of 
 his speech-disturbance, he feels less fear at its advent. 
 The impediment is more readily surmounted, and even 
 if it cannot be immediately overcome, it is at least 
 deprived of some of its terrors. 
 
 AUTO-SUGGESTION 
 
 If fear and auto-suggestion were the sole causes of 
 stammering, hypnotism would afford the natural 
 remedy for speech-defects.^ Many reliable hypno- 
 tists affirm that they have cured stammering by means 
 of suggestion, but the more rehable among them admit 
 that they have generally failed. 
 
 Hypnotism is used as an adjunct in some of the 
 *' stammering-schools" of Europe, more particularly 
 in those of Germany. The hypnotists, however, 
 treat merely the fear and lack of confidence of the 
 stammerer; thus they miss the primary cause of 
 
 1 Hypnotism is still regarded by a good many people as a species 
 of black magic. This deplorable ignorance is largely imputable to 
 the sensational press and the freebooters of the vaudeville. An 
 exposition on hypnotism is beyond the scope of this work. The 
 reader wishing information on hypnotism is directed to monographs 
 dealing with the subject. 
 
COROLLARIES 339 
 
 the speech-disturbance. The treatment would be 
 effectual if it were possible to intensify the auditory 
 imagery and to inhibit the amnesia by means of post- 
 hypnotic suggestion. This matter deserves thorough 
 investigation.^ 
 
 During the past few years psychoanalysis has been 
 employed in Europe in the treatment of stammering, 
 — the stammering being regarded as a fear-neurosis. 
 The method of treatment seems to be no more effica- 
 cious than the old elocutionary methods. Various 
 '^ psychological" methods are vaunted by stammering- 
 schools in Germany, England, Switzerland, and Russia; 
 but these ''methods" are generally Httle more than 
 advertising attractions, the principal "system" being 
 usually an elocutionary one. The psychological 
 methods may or may not possess inherent virtues ; 
 but they are usually applied by incompetents (men 
 that are neither physicians nor psychologists) ; hence 
 the success derived is generally nugatory. 
 
 Counter auto-suggestion is advocated by many 
 persons engaged in treating stammering. The stam- 
 merer is taught to combat his lack of confidence 
 with the counter-suggestions of "I can and I will," 
 etc. The "I can and will" business is practically 
 the whole stock in trade of many illiterate "speech 
 specialists." The trouble is that under their malev- 
 
 ^ The writer would be pleased to hear from investigators the re- 
 sults of any researches they may undertakein this field. 
 
340 THE PSYCHOLOGY OF STAMMERING 
 
 olent treatment, the stammerer can't and doesn't. 
 Mere brute-will accomplishes nothing, for the stam- 
 merer does not know what he is trying to accomplish. 
 He tries merely to speak, without knowing anything 
 of the psychological process. When the mental 
 imagery fails, the sheer "I will" leads to physical 
 effort. Counter-suggestion, when appHed in a general 
 way, is egregious nonsense. It may be efficacious in 
 counteracting fear and ''delusional behefs," but its 
 efficacy in any particular case will be determined 
 entirely by the temperament of the subject. A per- 
 son of emotional temperament might find counter- 
 suggestion extremely beneficial; but one possessed 
 of a cool, analytical mind would doubtless find it 
 futile. The former would do well to meet a difficult 
 situation with suggestions of his perfect confidence; 
 the latter would better refuse to think of the circum- 
 stance, — deliberately turning his thoughts to other 
 things and rel3dng upon an intelligent comprehension 
 of the psychological speech-processes to tide him over 
 difficulties.^ 
 
 Multiple Thought 
 
 There is no indirect method of attacking multiple 
 thought. The stammerer must simply reahze that 
 the verbal imagery is absolute in determining the 
 
 ^ The psychological systems currently employed in treating stam- 
 mering are discussed in Vol. II, Chap. VII. 
 
COROLLARIES 341 
 
 nature of speech. If the verbal images are not ex- 
 pressed clearly in thought, and expressed in orderly 
 consecution, the oral words cannot under any pos- 
 sible circumstances be clearly spoken. The stam- 
 merer is always tempted to substitute synonyms for 
 difficult words. The expedient permits him to enjoy 
 a transient immunity from his impediment. Ulti- 
 mately, of course, the use of synonyms aggravates 
 the disturbance by increasing mental confusion. 
 The stammerer must on many occasions choose be- 
 tween two evils. He may speak the words that rise 
 first in his mind, and stammer whenever difficulty 
 occurs; or he may re-frame his sentence whenever 
 he encounters an obstacle. The latter course affords 
 temporary immunity; and, since it is the path of 
 least resistance, it is the one that the stammerer will 
 frequently follow. The former, however, is the only 
 possible course for the stammerer to pursue if he is 
 finally to overcome his difficult}^ 
 
 When the impediment is severe, the stammerer 
 can readily overcome the tendency to employ syno- 
 nyms. He finds most words difficult ; consequently 
 it is an easy matter for him to treat them impartially. 
 When the disturbance is sHght, the stammerer is 
 tempted to conceal his impediment by resorting to 
 synonyms. It is the stammerer of the latter type 
 that will have the greatest difficulty in restraining 
 multiple thought. 
 
342 THE PSYCHOLOGY OF STAMMERING 
 
 It is not advisable for the average stammerer to 
 frame each sentence before speaking it, though he is 
 frequently advised to do so. This method of think- 
 ing the words first and speaking them afterward is 
 entirely unnatural. The average stammerer would 
 be tempted to pick and choose his words while fram- 
 ing the sentence, and confusion would ensue even in 
 this preHminary thought. Further, the appearance 
 of a difficult word in the sentence would augment the 
 speaker's fear and thus increase his predicament. 
 It is better for the stammerer to speak each word as it 
 rises in his mind and to treat difficult and easy words 
 impartially. If he is greatly tempted to replace 
 difficult words by synonyms, he might find it desir- 
 able (if he visualizes readily) to hold a visual image 
 of the refractory word before his mind. This image 
 would focus the attention, and to some extent counter- 
 act the tendency to substitute. 
 
 Distortion of Imagery 
 
 Distorted verbal imagery is easily corrected if 
 the stammerer can find any circumstance under 
 which he can speak with fluency. Even if the 
 stammerer cannot speak with fluency when alone, 
 he can usually enunciate freely when speaking in 
 unison with another person, or when repeating the 
 words that another person has just uttered. Suffi- 
 cient practice in natural speech under these condi- 
 
COROLLARIES 343 
 
 tions, or under any conditions, will restore the verbal 
 imagery. 
 
 Stammering that has been induced by imitation or 
 association is usually compKcated by such secondary 
 causes as inhibitive auto-suggestion and fear. These 
 causes must, of course, be combated as well as the 
 distortion of the imagery. The stammerer must 
 determine for himself to what extent unnatural im- 
 agery is responsible for unnatural speech. If he 
 speaks fluently when alone, it is certain that the dis- 
 tortion of the imagery is not solely responsible for the 
 speech-disturbance, — unless, of course, he finds that 
 distorted images are redintegrated only in an un- 
 favorable environment. Such a condition of affairs 
 seems, however, highly improbable. In any case, 
 distorted imagery is easily rectified ; and when the 
 impediment is due solely to this cause, it can be readily 
 overcome. 
 
 Physical Stammering 
 
 Physical stammering is easily eradicated by elocu- 
 tionary methods. In most cases it can be eHminated 
 in two or three weeks by careful training. By remov- 
 ing the secondary symptoms of amnesia, elocutionary 
 training often seems to effect a miraculous improve- 
 ment within a brief space of time ; but the improve- 
 ment seldom progresses to a cure, for the amnesia 
 remains unalleviated. 
 
 The intractability of a case is proportional to the 
 
344 THE PSYCHOLOGY OF STAMMERING 
 
 severity of the amnesia and not to the severity of the 
 physical stammering. Bell has remarked that^ — 
 
 "A case of apparently slight impediment is frequently 
 more tedious and difficult to cure than one of the most bois- 
 terous and convulsive aspect." ^ 
 
 The boisterous and convulsive aspect results from 
 physical stammering, and it can be readily eliminated. 
 It bears no necessary relation to the severity of the 
 amnesia. The amnesia may be severe and no physical 
 stammering be present. Liebmann says of a partic- 
 ular case of passive stammering : ^ 
 
 "One can see plainly that the patient wishes to answer; 
 but she cannot do so, either aloud or in a whisper. One can 
 detect no articulatory movements, and the pneumograph shows 
 a normal respiration-curve. Only after some time does the 
 patient begin to speak; and then she does so in a fluent and 
 normal manner. The patient says that she knows the answer, 
 but is simply unable to say it." * 
 
 In cases of this nature there is no physical stam- 
 mering, and elocutionary methods would be practi- 
 cally unavailing. 
 
 Of the elocutionary systems it may be said that 
 most of them will rectify the stammerer's errors of 
 
 ^ "Principles of Speech," 5th ed., p. 236. 
 
 ? See also H. Gutzmann, "Sprachheilkunde," 2d ed., pp. 446-447. 
 
 ' "Vorlesungen iiber Sprachstorungen," i. Heft, p. 27. 
 
 * See also p. 209 of this volume for Gutzmann's statement, 
 "There are stammerers that never stumble in speech, but that 
 stammer, nevertheless." 
 
COROLLARIES 345 
 
 respiration, phonation, and articulation; and that 
 most of them are therefore good so far as they go. 
 The trouble is that they do not go far enough: they 
 treat only the symptoms, but not the cause of the 
 speech-defect. 
 
 A detailed discussion of the merits and demerits of 
 the various systems is, of course, beyond the scope 
 of the present chapter : the subject has been reserved 
 for the succeeding volume. A few general remarks 
 at this point may, however, be pertinent. 
 
 It may be stated that the time-beating system — 
 which has its widest vogue in America — is directly 
 pernicious, since it distorts the stammerer's verbal 
 imagery.^ 
 
 Many systems viciously overemphasize articulation, 
 and thus tend to confirm an erroneous attitude that 
 most stammerers have toward speech. The average 
 stammerer gives the greater part of his attention to sen- 
 sations from the speech-organs, and very little attention 
 to the verbal image by which the word is initiated. The 
 afferent stimuH, however, do not facihtate utterance ; 
 rather they divert attention from the point on which 
 it should be focussed. Hence any system that over- 
 emphasizes articulation is nocuous in such respect. 
 
 Under some elocutionary systems the pupil is taught 
 to note the words on which he stammers, and to 
 practise these words together with various alKterations 
 * This remark applies to any system based upon rhythm. 
 
346 THE PSYCHOLOGY OF STAMMERING 
 
 that introduce the '^difficult consonants." The 
 practice is pernicious, since it establishes fear-associa- 
 tions. The stammerer acquires fear of certain words 
 and letters; and when these words or letters recur, 
 fear augments his difficulty. The practice develops 
 lalophobia, but does absolutely no good to compensate 
 for the evil it engenders. 
 
 Pure Stammering 
 
 It is evident that after the stammerer has overcome 
 physical stammering, distortion of the imagery, 
 multiple thought, fear, and inhibitive auto-suggestion 
 
 — all these being secondary causes or manifestations 
 of the defect — he has still the auditory amnesia to 
 contend with. At best he has reduced his complex 
 stammering to pure stammering : he has reduced the 
 disturbance to its lowest terms. But in many cases 
 no severe stammering will remain, and the sHght 
 remnant of the defect may cause little inconvenience. 
 The auditory amnesia is often induced by the secon- 
 dary causes, and so may disappear when these causes 
 are removed. However, this is not invariably the 
 case; hence we have to consider the question of 
 obviating the amnesia itself. 
 
 Two questions naturally suggest themselves : First 
 
 — Can the refractory auditory image be goaded into 
 activity by artificial means ? Secondly — Can the 
 auditory image be strengthened so that it will be 
 
COROLLARIES 347 
 
 less likely to vanish ? ^ These two questions must be 
 considered at length. 
 
 There seems to be no doubt that auditory sensa- 
 tions facilitate the redintegration of auditory images. 
 Paulhan remarks that the sound of a train or a water- 
 fall m^akes it easier for him to recall tunes in auditory 
 memory.^ Illusions of hearing are common, — un- 
 doubtedly more common than those of sight. This 
 fact shows that auditory images are easily awakened 
 by more or less irrelevant auditory impressions. In 
 certain cases one is absolutely dependent upon audi- 
 tory sensations for the arousal of auditory images. 
 For instance, there are many people with weak audi- 
 tory imagery that can whistle a tune audibly, though 
 they cannot whistle in mental imagery. It is per- 
 fectly clear that they do not recall the tune in kin- 
 aesthetic imagery ; hence the auditory images of the 
 various notes must be aroused by the acoustic sen- 
 sations from the notes that precede them. 
 
 ^ There can, of course, be no assumption of function by the op)- 
 posite hemisphere of the brain. The defect in the auditor>' centre 
 appears to be usually functional rather than organic, and the stam- 
 merer is not incapacitated for silent thought. Hence, even in young 
 children no transference of function takes place. Any lesion that is 
 sufficiently severe to occasion transference of function is sufficiently 
 severe to induce aphasia rather than stammering. Transference of 
 function, in cases of stammering, is therefore out of the question. 
 
 2 "Le langage int^rieur" {Revue philosophique, Janvier, 1866, p. 
 34). Cited by Ballet, "Le langage int6rieur," 2d ed., p. 22. 
 
348 THE PSYCHOLOGY OF STAMMERING 
 
 Most stammerers find that they can speak better in 
 the presence of sounds that the average person would 
 consider distracting. The noise of a train, the clatter 
 of vehicles, or the sound of voices seems to exert a 
 beneficial influence upon the stammerer's speech. 
 The sound of human voices is particularly salutary. 
 The average stammerer finds that he can speak with 
 unusual fluency if a number of persons happen to be 
 speaking within hearing-distance. The explanation 
 for this fluency is that the auditory sensations 
 faciHtate the arousal of the auditory images reqmsite 
 for speech. It seems as though activity in the cells 
 subserving the sensations renders the contiguous cells 
 more excitable. 
 
 Lunn says : ^ 
 
 "It has often been remarked that deaf people hear best in 
 a noise, as in railway travelling." 
 
 Here, again, we must suppose that the extraneous 
 sotmds assist in overcoming the inertia of the auditory 
 cells. 
 
 The fact that an acoustic sensation may awaken 
 the refractory auditory image affords a cogent reason 
 why the stammerer should commence the articula- 
 tion of a word even if its auditory image is not at once 
 forthcoming. The initial consonant can be produced 
 by kinaesthetic cues ; and the sound of this consonant 
 
 , ^ The Voice, Vol. V, p. 133. 
 
COROLLARIES 349 
 
 will often arouse the indolent auditory image — or 
 intensify it if it should be too weak to prompt the 
 enunciation of a word. Further, the kinaesthetic 
 sensation tends to arouse the auditory image by as- 
 sociation. When the association is itself inadequate, 
 the sound-irnpression may often turn the balance. 
 
 There is another cogent reason why the stammerer 
 should commence the articulation of a refactory word. 
 The concentration of attention upon the word ehmi- 
 nates multiple thought and vacillation of the will — 
 elements that might otherwise exert a disturbing in- 
 fluence. The procedure advocated will, of course, 
 occasionally introduce pure stammering in place of a 
 silent pause. On the other hand, it will often obviate 
 stammering and pauses entirely. Its advantages on 
 the whole greatly outweigh any disadvantages that it 
 might be thought to entail. 
 
 It is interesting to note that many empirical sys- 
 tems have taken advantage of this tendency of the 
 auditory sensation to awaken the sound-image. The 
 stammerer is frequently told to prelude his words 
 with a short e (e) or with the sound of the consonant 
 m or n. The word yes then becomes eh-yes, m-yes, or 
 n-yes. This artifice is thought to enable the stam- 
 merer to vocalize after the consonant has been articu- 
 lated, it being assumed that the stammerer's diffi- 
 culty lies with phonation. The vocaHzation is supposed 
 to continue during the articulation of the consonant, 
 
350 THE PSYCHOLOGY OF STAMMERING 
 
 and the stammerer is admonished to maintain con- 
 tinuity of sound throughout the sentence. There can, 
 of course, be no such continuity, for vocalization ceases 
 with every surd consonant. If the initial consonant is 
 mute, vocalization is interrupted even between the in- 
 troductory sound and the vowel. It is thus evident 
 that the introductory sound does not perform the 
 fimction attributed to it. If it renders assistance at 
 all, it does so by arousing the torpid auditory image. ^ 
 It seems possible that the auditory image might 
 be aroused more readily if it were associated with 
 some visual image that could be clearly and promptly 
 redintegrated. The visual image would then form 
 a nucleus to which one could resort if the auditory 
 image were not at once forthcoming. It would hold 
 attention for the sound required, and tend to arouse 
 this sound by association. In many cases there seems 
 to be no difficulty whatever in reviving the auditory 
 image when an associated visual nucleus is present. 
 Many stammerers can read without difficulty, though 
 they cannot carry on a fluent conversation. It will 
 be remembered that even aphasic patients are some- 
 times able to read fluently when they are incapable 
 of spontaneous speech. The rationale of this seems 
 to be that the visual stimulus arouses the auditory 
 
 ^ The stammerer is not recommended to resort to the unnatural 
 expedient described. This particular device is cited merely to 
 illustrate the principle under discussion. 
 
COROLLARIES 351 
 
 image by association, or that it arouses the kin- 
 aesthetic image directly, acting itself as a remote in- 
 citing image. But whatever the subjective process 
 may be, it is certain that visual verbal images often 
 facilitate speech. The stammerer that can read with 
 fluency should have Httle difl&culty in speech if he 
 could bring before his mind visual images of the words 
 that he utters. The process would be analogous to 
 ordinary reading. 
 
 Many subjects would have no difficulty in visualiz- 
 ing words during speech, but others would find the 
 visuahzing of polysyllabic words practically impossible. 
 The idea naturally suggests itself that one might visu- 
 alize only the vowel, for the visual image of the vowel 
 should tend to arouse the mental image of its sound. 
 The phenomenon of chromsesthesia, or color-audition, 
 suggests further that one might visualize the printed 
 or written vowels in colors or upon colored back- 
 grounds. This would make visuaHzation easier for 
 a person possessed of strong color-imagery, and in 
 many instances would facilitate visuaHzation of the 
 entire word. This visuaHzing of colored words and 
 colored vowels, it will be remembered,^ is quite natural 
 with some persons; and when the color-imagery is 
 naturally strong, it does not prove at all distracting. 
 Galton says in reference to the phenomenon : - 
 
 1 See p. 39. 
 
 '"Inquiries into Human Faculty and its Development," p. 148. 
 
352 THE PSYCHOLOGY OF STAMMERING 
 
 "I will simply remark — First, that the persistence of colour 
 association with sounds is fully as remarkable as that of the 
 Number-Form with numbers. Secondly, that the vowel sounds 
 chiefly evoke them. Thirdly, that the seers are invariably 
 most minute in their description of the precise tint and hue of 
 the colour. They are never satisfied, for instance, with saying 
 'blue,' but will take a great deal of trouble to express or to 
 match the particular blue they mean. Fourthly, that no two 
 people agree, or hardly ever do so, as to the colour they associate 
 with the same sound. Lastly, that the tendency is very heredi- 
 tary." 
 
 Galton quotes the following description of vowel- 
 imagery by "Mrs. H., the married sister of a well- 
 known man of science " : ^ 
 
 "'I do not know how it is with others, but to me the colours 
 of vowels are so strongly marked that I hardly understand 
 their appearing of a different colour, or, what is nearly as bad, 
 colourless to any one. To me they are and always have been, 
 as long as I have known them, of the following tints : — 
 
 "M, pure white, and like china in texture. 
 
 "'£, red, not transparent; vermilion, with china-white, 
 would represent it. 
 
 " ' /, Hght bright yellow ; gamboge. 
 
 " ' O, black, but transparent ; the colour of deep water seen 
 through thick clear ice. 
 
 " ' U, purple. 
 
 " ' F, a dingier colour than /. 
 
 "'The shorter sounds of the vowels are less vivid and pure 
 in colour. Consonants are almost or quite colourless to me, 
 though there is some blackness about M. 
 
 * Loc. cit.y pp. 150-151. 
 
COROLLARIES 353 
 
 "'Some association with U in the words blue and purple 
 may account for that colour, and possibly the E in red may have 
 to do with that also ; but I feel as if they were independent of 
 suggestions of that kind. 
 
 "'My first impulse is to say that the association lies solely 
 in the sounds of the vowels, in which connection I certainly 
 feel it most strongly; but then the thought of the distinct 
 redness of such a [printed or written] word as " great '^ shows 
 me that the relation must be visual as well as aural. The mean- 
 ing of words is so unavoidably associated with the sight of them, 
 that I think this association rather overrides the primitive 
 impression of the colour of the vowels, and the word "violet" 
 reminds me of its proper colour until I look at the word as a 
 mere collection of letters. 
 
 " 'Of my two daughters, one sees the colours quite differently 
 from this {A, blue; E, white; /, black; O, whity-brownish ; 
 U, opaque brown). The other is only heterodox on the A 
 and ; A being with her black, and white. My sister and 
 I never agreed about these colours, and I doubt whether my 
 two brothers feel the chromatic force of the vowels at all.'" 
 
 Another correspondent says that A is brown, vary- 
 ing in shade according to the ''openness" of the vowel. 
 E is clear, cold, hght-gray blue. / is associated with 
 black and with white. The correspondent sug- 
 gests that the soHd type in / and the open space in O 
 may explain the colors with which these letters are 
 associated. R is copper-colored. This correspondent 
 gives the word visualization represented in streaks of 
 color, and proceeding conversely gives the verbal 
 interpretation of the colors in several scraps of wall- 
 paper. 
 
354 THE PSYCHOLOGY OF STAMMERING 
 
 Obviously, it would be an easy matter for the stam- 
 merer to establish associations of this kind.^ The 
 associations would doubtless be beneficial to the 
 stammerer that is assisted by visual impressions in 
 reading. Theoretically, the associations should prove 
 beneficial in any case. The writer has made no in- 
 vestigations along this line. The matter has been 
 discussed merely to suggest a possible method by 
 which the auditory image might be aroused through 
 associational channels. 
 
 Many psychologists have expressed the opinion that 
 the mental imagery itself can be directly developed and 
 intensified. Unfortunately, most accounts of image- 
 training deal exclusively with the visual imagery. 
 However, it seems reasonable to suppose that if the 
 optical images can be developed, the acoustic images 
 can be developed also. For developing the visualiz- 
 ing faculty, Galton advocates the practice of retaining 
 the primary memory-image and examining it for 
 details that escaped observation during actual per- 
 
 * The association is one of temporal contiguity. One must 
 receive simultaneous impressions through the sense of hearing and 
 the sense of sight. One pronounces the vowel-sound while looking 
 at the object (colored letter, solid color, or white letter on a colored 
 background) with which it is to be associated. Afterward, the 
 vowel-sound is associated with its letter or color in mental imagery. 
 For preference, the short vowels should be associated with the more 
 vivid colors. 
 
COROLLARIES 355 
 
 ception. He also advocates the practice of multiply- 
 ing associations. Concerning the latter point he says : ^ 
 
 "The chief art of strengthening visual as well as every form 
 of memory, lies in multiplying associations ; the healthiest 
 memory being that in which all the associations are logical, 
 and toward which all the senses concur in their due proportion. 
 It is wonderful how much the vividness of a recollection is 
 increased Vv^hen two or more lines of association are simulta- 
 neously excited. Thus the inside of a known house is much 
 better visualized when we are looking at its outside than when 
 we are away from it, and some chess-players have told me that 
 it is easier for them to play a game from memory when they 
 have a blank board before them than when they have not." 
 
 In another place the writer says : ^ 
 
 "There is abundant evidence that the visualizing faculty 
 admits of being developed by education. The testimony on 
 which I would lay especial stress is derived from the pubhshed 
 experiences of M. Lecoq de Boisbaudran, late director of the 
 Ecole Nationale de Dessein, in Paris, which are related in his 
 " Education de la Memoire Pittoresque." ^ He trained his pupils 
 with extraordinary success, beginning with the simplest figures. 
 They were made to study the models thoroughly before they 
 tried to draw them from memory. One favorite expedient was 
 to associate the sight memory with the muscular memory, by 
 making his pupils follow at a distance the outlines of the figures 
 with a pencil held in their hands. After three or four months' 
 practice their visual memory became greatly strengthened. 
 They had no difficulty in summoning images at will, in holding 
 
 * Loc. cit., p. 108. 2 i^Q(^^ c//^ pp 105-106. 
 
 ^ " Republished in an 8vo, entitled * Enseignment Artistique.* 
 Morel et Cie, Paris, 1879." 
 
356 THE PSYCHOLOGY OF STAMMERING 
 
 them steady, and in drawing them. Their copies were executed 
 with marvellous fidelity, as attested by a commission of the 
 Institute, appointed in 1852 to inquire into the matter, of which 
 the eminent painter Horace Vernet was a member. The present 
 Slade Professor of Fine Arts at University College, M. L^gros, 
 was a pupil of M. de Boisbaudran. He has expressed to me 
 his indebtedness to the system, and he has assured me of his 
 own success in teaching others in a somewhat similar way." 
 
 In spite of this opinion it seems to be a moot ques- 
 tion whether the visual images were actually intensi- 
 fied. Many of the subjects may have been motiles, 
 and their improvement in drawing may have been due 
 to the fact that they relied upon the motor as well as 
 the visual memory. However, Galton is not ambigu- 
 ous in his opinion concerning the possibility of in- 
 tensifying the visual images themselves, for he says : ^ 
 
 "I could mention instances within my own experience in 
 which the visualizing faculty has become strengthened by 
 practice ; notably one of an eminent electrical engineer, who 
 had the power of recalling form with unusual precision, but not 
 color. A few weeks after he had replied to my questions, he 
 told me that my inquiries had induced him to practise his 
 color memory, and that he had done so with such success that 
 he was become quite an adept at it, and that the newly acquired 
 power was a source of much pleasure to him." 
 
 A single report of this kind is worth a hundred 
 general opinions concerning the possibility of training 
 the mental imagery. Unfortunately, such reports are 
 rare. 
 
 * Loc. cii.y pp. 106-107. 
 
COROLLARIES 357 
 
 An interesting account of "An Attempt to Train 
 the Visual Memory" appears in the American Journal 
 of Psychology} The writer says of her mental imagery 
 previous to the experiment : 
 
 "It was predominantly verbal-auditory and verbal-motor, 
 with the first factor a little in the lead. 
 
 "The direct visual memory was somewhat developed, though 
 not to the same degree as in most persons. E.g., the name of 
 some one whom I knew rather well would almost invariably 
 call up a visual image, and with some effort I could make its 
 details (form and color) fairly distinct. On the other hand, as 
 I now see upon looking back, class-names very seldom called 
 up a visual impression. 
 
 - " My verbal-visual memory was very defective. Dates I or- 
 dinarily visualized, but not words. So far as I know, I had never 
 at this time had a visual picture of a written or printed word. 
 Of course it is possible, however, that just as one may have a 
 visual local sign without being aware of it until one's attention 
 is called to the matter, so I may have had visual-verbal images, 
 which served their purpose in associations without rising into 
 distinct consciousness." 
 
 When listening to reading, the writer was never 
 conscious of visualized words appearing before her 
 mind. She seemed to hear the words again in her 
 own voice and feel them forming in her throat. This 
 imagery was, of course, both auditory and kin- 
 aesthetic. 
 
 The method pursued in developing the visualizing 
 faculty was to read a few Hnes of poetry; then to 
 
 iVol. Vni, pp. 4i4ff- 
 
358 THE PSYCHOLOGY OF STAMMERING 
 
 close the eyes and give as full a description as possible 
 of the disposition of the lines and words, and any de- 
 tails that could be remembered. This description 
 was recorded, and its accuracy tested by reference to 
 the original page. In another exercise, Japanese 
 pictures were scrutinized for ten seconds and then 
 roughly sketched from memory, the sketch being 
 supplemented by an oral description. Comparison 
 was then made with the original. 
 
 Concerning the results at the end of six months' 
 practice, the writer says : 
 
 "With the poetry my work improved steadily from first 
 to last. At the outset six or seven lines was as much as I 
 could keep in mind at once ; near the close of the work I could 
 sometimes give from twenty to twenty-five without a mistake. 
 It must be confessed, however, that I did not always succeed 
 in making my memory purely visual; often I found myself 
 remembering the length of a fine in terms of eye-movements. 
 
 " With the pictures the progress was not so evident. Natu- 
 rally it was harder in this case to say whether one was improving 
 or not ; especially as each picture in the set was given several 
 times. I am inclined to think there was a slight improve- 
 ment, but it certainly was not marked. . . . 
 
 "At the present time, seven months after the conclusion 
 of the work, I notice considerable improvement, both in the 
 direct visual and in the verbal-visual memory. In attempting 
 very recently to commit some poetry, I found myself depending 
 to a considerable extent upon my verbal- visual memory, whereas 
 a year and a half ago I should have relied wholly upon my 
 verbal-auditory and verbal-motor memories. The effect of 
 the change was apparent rather in greater accuracy than in in- 
 
COROLLARIES 359 
 
 creased speed of memorizing. In my general reading, too, I 
 have more pictures than I used to have. I am not conscious 
 of visualizing any better than formerly — i.e., with any more 
 detail, — but I am conscious of visuahzing more frequently." 
 
 One would judge from this report that there was 
 certainly no marked change in the intensity of the 
 visual images. The results do not strongly support 
 the notion that the mental images are always re- 
 sponsive to training. Nevertheless, opinions similar 
 to the following are frequently expressed by psy- 
 chologists : ^ 
 
 "It is astonishing to observe how rapidly this capacity for 
 visuaHsing unfolds in response to a little systematic effort and 
 practice. By devoting to the task a few minutes each day for a 
 week, one may learn to visualise with great detail and remark- 
 able accuracy the form, size, color, etc., of even large and com- 
 plex objects, such, for example, as great buildings. Frequently 
 at the outset we find that our images are relatively faint, meagre, 
 and unstable; they lack vividness and veracity in color, 
 detail in form, and appropriate dimensions in size. Images of 
 other varieties, auditory, for instance, are similarly defective 
 at times, and yield as a rule to discipline with a corresponding 
 form of development." 
 
 Direct accounts of attempts to train the auditory 
 imagery are extremely rare in the literature of psy- 
 chology. General statements that the development 
 can be effected are, on the contrary, common enough. 
 The method to be pursued is evident. One must 
 
 * Angell, "Psychology," pp. 218-219. 
 
36o THE PSYCHOLOGY OF STAMMERING 
 
 attend closely to the auditory sensations (which 
 should be made as clear and sharp as possible), and 
 must allow the primary image to "ring" through the 
 mind. One must continually recall the image, and 
 must endeavor to preserve its fidelity. Secondary 
 memory-images must likewise be made the subject 
 of attention, and one must endeavor to increase the 
 intensity of the image with each repetition. The 
 whole matter is simply one of introspection and at- 
 tention. It is practically certain, however, that 
 whatever results may be accomplished by this method 
 do not endure imless the mental images are frequently 
 subjected to introspective scrutiny. 
 
 An ephemeral strengthening of the auditory imagery 
 seems to be effected by some of the more successful 
 systems of elocutionary training. This fact accounts 
 for the isolated temporary cures accomplished.^ For 
 several hours a day the stammerer is drilled upon 
 vocal exercises, many of which emphasize the vowel ; 
 and for several hours more he reads aloud in order to 
 comply with the requirements of the "system." 
 As a result of this practice the auditory imagery is 
 
 ^ Other reasons for the "cures" can also be assigned. Fear and 
 physical stammering are generally eliminated, — the former by the 
 stammerer's confidence in the system, and the latter by the atten- 
 tion given to the conditions required for natural speech. Multiple 
 thought is also precluded for a time by the attention given to various 
 "rules of speech." Thus most of the secondary causes of stammering 
 are temporarily removed. 
 
COROLLARIES 361 
 
 temporarily intensified, and stammering disappears. 
 When the exercises are discontinued or practised less 
 frequently, the auditory imagery reverts to its former 
 condition, and the stammerer relapses on account of 
 *' carelessness." 
 
 It is not, however, merely to the intensification of 
 the auditory imagery that the stammerer must look 
 for rehef. The auditory imagery is too unreliable 
 and treacherous to warrant confidence in any mitiga- 
 tion of the impediment that its transient intensity may 
 effect. With the occurrence of an illness the imagery is 
 often weakened, and stammering naturally recurs. It 
 is the usual experience of even the cured stammerer 
 that the impediment returns with its old vigor when 
 he is stricken with some debihtating disease. The 
 writer could cite several instances in which principals 
 of ''stammering-schools" have themselves suffered 
 a complete relapse. It is probable that such relapses 
 would be only temporary if the stammerer understood 
 the prevaiHng conditions. Fluency of speech would 
 return when the auditory imagery regained its former 
 intensity. However, the stammerer does not under- 
 stand the conditions ; hence he falls a victim to the 
 secondary causes. 
 
 But, if a complete and permanent cure is to be 
 effected, the stammerer must cease to be dependent 
 upon auditory images ; for, so long as he reUes upon 
 these images as speech-cues, he must inevitably stam- 
 
362 THE PSYCHOLOGY OF STAMMERING 
 
 mer when amnesia occurs. If it is possible, the stam- 
 merer must learn to depend upon kinaesthetic and 
 visual cues ; i.e. he must become an articulo-moteur 
 or a visuo-moteur. It is probable that the stam- 
 merer can never disregard his auditory images entirely, 
 but if he can supplement them by efficient motor 
 and visual speech-cues, he may be independent of the 
 auditory images when amnesia occurs. But the 
 acquired verbal images will be worthless if they can 
 be recalled only through association with the auditory 
 images. The acquired images must be estabHshed as 
 integral and independent parts of the verbal concept, 
 so that the stammerer can redintegrate them directly , 
 and speak, like the congenitally deaf person, from 
 kinaesthetic and visual cues.^ 
 
 *The average stammerer would probably find it difficult to 
 develop his kinaesthetic verbal imagery by simply attending to the 
 sensations that the speech-movements produce. He might, how- 
 ever, be assisted by visualizing the movements he is endeavoring to 
 feel. He would probably find the kinaesthetic impressions from the 
 vowels more distinct if the acoustic sensations were excluded from 
 consciousness. This exclusion could not be accomplished by merely 
 sealing the ears. The vocal sound-waves would have to be obliterated 
 by other sound introduced to the auricular canals. (For this pur- 
 pose, some such simple apparatus as a stethoscope and an electrical 
 "buzzer" could be employed.) 
 
 The stammerer would establish his visual cues, like the deaf 
 person, by observing the action of the speech-organs in other sub- 
 jects, and by observing the action of his own speech-organs in the 
 mirror. (Literature on the training of the deaf can be obtained 
 from The Volta Bureau, Washington, D.C.) He might possibly 
 
COROLLARIES 363 
 
 Teachers of the deaf have in the past often under- 
 taken the treatment of stammering, but they have 
 not generally met with success. The probable reason 
 for their failure is that they have attempted to teach 
 the stammerer to articulate (a thing that he can do 
 perfectly well), and that they have neglected the 
 secondary causes of stammering. The staramerer 
 does not need to be taught to articulate, for his 
 difficulty is m-crely to produce the correct color of the 
 vowel. If he is to discard his auditory imagery, he 
 must learn to mentally see and feel the different con- 
 formations of the oral cavity corresponding to the 
 vowels that he has formerly ''heard." He has to 
 learn vowel-positions rather than consonant-move- 
 ments. Whether or not this can be readily accom- 
 plished, and whether the average stammerer can 
 voluntarily ignore his auditory imagery and dehber- 
 ately resort to artificially acquired cues, remains yet 
 to be ascertained by numerous actual experiments. 
 
 The writer has so far made no investigations along 
 this particular line. It is for the reason that he will 
 be unable to make extensive investigations in the 
 immediate future that he pubHshes the results of his 
 
 make some practical use of Bell's "visible speech" symbols. (See 
 Bell's "Visible Speech," etc.) If he visualizes readily, he might 
 picture the words in "visible speech," or in a combination of "visible 
 speech" vowels and ordinary alphabetic consonants. The field of 
 investigation is still unexplored, and it is difficult to state what the 
 most desirable procedure would be. 
 
364 THE PSYCHOLOGY OF STAMMERING 
 
 researches while yet unable to supply the answer to 
 one of the vital questions involved. The writer does 
 not presume, however, to have solved the whole 
 problem of the cause and cure of stammering. This 
 monograph represents, in the main, an attempt to 
 explain the cause of stammering, and to indicate 
 the direction in which the writer believes the only 
 radical and reliable cure is to be found. It is hoped 
 that this volume will carry the necessary conviction 
 to stimulate investigation in the direction suggested. 
 Yet, whatever the success that may attend the visual 
 education of the stammerer, it is certain that the 
 logical method of handhng the defect is to attack the 
 primary disturbance at its very inception — during 
 early childhood — and not first to await the develop- 
 ment of compHcations. If the amnesia is severe, the 
 child can be converted from an audito-moteur to an 
 articulo-moteur. If the amnesia is not severe, it can 
 generally be counteracted. If the child is taught to 
 suppress all excitement, and to think of the words 
 he is going to utter — to think how they are going to 
 sound — he can usually overcome his amnesia. 
 Childhood is the age of plasticity, and in early life 
 one accompHshes with consummate ease what in 
 later years becomes a matter of impossibility. If 
 the primary cause of stammering is allowed to persist, 
 the secondary causes quickly supervene, and pure 
 stammering becomes stammering in its complex form. 
 
COROLLARIES 365 
 
 But even under these conditions, stammering is more 
 easily remedied at an early age. 
 
 A few of the progressive municipalities of Europe 
 and America have instituted special courses in the 
 public schools for the instruction of stammering chil- 
 dren. Where the system of instruction has not been 
 lacking in merit, the results have invariably been 
 propitious. The proportion of cures effected is in 
 some accounts given as high as 80 per cent. Even the 
 more conservative reports state that a majority of the 
 children are cured, and that a large proportion of those 
 not cured are greatly benefited by the instruction.^ 
 There can be absolutely no doubt that in thousands 
 of cases stammering can be eradicated in early child- 
 hood, when it would not be amenable to treatment in 
 later Hfe. 
 
 It is the obvious duty of every municipality to 
 institute courses of instruction for stammering chil- 
 dren, that later they be not '^baffled at every turn of 
 life, for want of that most common privilege of man." 
 
 1 See Brockhaus Enzyklopddie (14th ed., Vol. 17; article "Stam- 
 meln und Stottern"; also Medizinish-pddagogische Monatsschrift fur 
 die gesamte Sprachheilkunde, May, 1894, and other issues; also 
 Werner's Magazine (New York), February, 1895. 
 
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