3o SYSTEMS OF TREATING STAMMERING "Concerning the essential factor in stammering I would express myself as follows: Stammering consists in a temporary ineptitude in the management of the voice — which ineptitude may be conditioned by various influences. There is inability to impart to the vocal cords the proper degree of tension for the production of voice and then to expel the breath through the glottis in a stream sufficient to set the cords in vibration."l "Both impediments (stammering and stuttering) are fre- quently found in the same person, and both are due to the same cause — inability to vocalize." 2 It has already been remarked (Vol. II, p. 4) that failure of the voice is often ascribed to a failure of the expiratory current. Failure of voice is also ascribed to spasm of the vocal cords (Arnott, Miiller, Schul- thess, and others), and occasionally to general throat- contraction. Concerning the latter cause one writer remarks:3 "If we begin to speak at any point above the diaphragm, the speech suffers according to the location, the amount1 of misplaced energy and the temperament of the speaker. If all the energy is centred at any such point, there can be no speech, because it is only force in the breathing-muscles that can drive the breath against the vocal cords; and as the breath, whether vocalized or not, must pass through the glottis, it is plain that if the muscles at the glottis tie up the passage, the speech is hindered in the degree of the force of the contraction. 1 Wyneken, "ITeber das Stottern und dessen Heilung," p. 15. * Behnke, "On Stammering, Cleft-Palate Speech, Lisping," p: 10. 3 Thorpe, "Speech-Hesitation," pp. 30, 75.