14 SYSTEMS OF TREATING STAMMERING

either measured by a metronome, or is given by an
instructor, who leads the class with a baton or beats
time with the hand. In some institutions charts are
dispensed with, and the instructor leads the class with
a baton and gives directions orally or by gestures.
When the pupils practise alone, they usually take
the time from a metronome or count mentally.

In many institutions the various sets of breathing-
muscles — the chest muscles, intercostal muscles,
dorsal muscles, etc. — are exercised separately. The
following exercises are quite commonly prescribed:

Upper Chest Breathing! — Place the hands upon the chest,
with the tips of the fingers on the clavicles. Inhale slowly,
filling the upper part of the thorax so that the expansion can
be distinctly felt beneath the hands. Inhibit movements of
the shoulders, and as far as possible movements of the muscles
controlling the lower part of the thorax. Exhale slowly when
the upper chest has been fully expanded. Practise the various
simple respiratory exercises, using upper chest breathing.

Costal Breathing? — Place the hands upon the lower ribs,
with the fingers pointing forward and the thumbs back. In-
hale slowly, expanding the lower thorax laterally so that the
movement can be felt beneath the hands. Suppress upper
chest breathing as far as possible. Exhale slowly after inhala-
tion is complete. Practise the simple exercises, employing
costal breathing.

Exercise the costal muscles unilaterally, effecting the move-
ment first on the left side and then on the right.

1 Also designated clavicular breathing, collar-bone breathing, shoulder
breathing, etc.

2 Also designated lateral breathing, side breathing, rib breathing, etc.