But he decided to postpone action until some later date, feeling sure, despite what I had told him, that he would outgrow his stammering.

Four and a half years later, he came back. This time he did not say that his friends knew nothing of his trouble. He was in bad condition, his "seldom stammering," as he had called it, was chronic now and the painful expression on his face when he tried to talk was ample proof of the condition in which he had allowed himself to get. His trouble had passed into Genuine Stammering and was of a very severe nature. There was no thought of postponement in his mind at this time and he placed himself for treatment immediately. Eight weeks' time saw his work completed, with excellent results. His fear was gone, his confidence renewed and his health greatly improved, in addition to being able to talk fluently.

Case No. 66.788—Here was the case of a man of 30, a preacher, who found no difficulty in preaching to his congregation, from the pulpit, but whose trouble immediately got the best of him the moment he went down into the church and attempted to carry on a conversation individually. This became so embarrassing to him that he finally gave up the idea of passing through his congregation, but satisfied himself with standing at the door and greeting them as they passed out. This, too, he was later compelled to give up on account of his speech, although during none of this time did he have the slightest trouble in delivering his sermons.

His was a case of Genuine Stammering. The mental control when he was in the pulpit was almost normal. Talking to individuals, this control was quickly shattered. He placed himself for treatment after having secured a brother-pastor to fill his place for two months. He was a good student, obedient to instruction, concentrating on his work with a creditable energy. As a result, in five weeks' time, he found himself able to talk to anybody under any condition without the slightest sticking or fear. He could talk over the telephone and was master of himself under the cross-fire of conversation which in his previous state had bothered him so seriously.

Case No. 48.336—This is a case that represents a very common type of Combined Stammering and Stuttering, and a type that is not so quickly cured as might be imagined. This was a young man of 18, who not only stammered but stuttered. His speech disorder, however, was further complicated by a bad habit of prefixing a totally foreign word or sound to the word or sound which he found it difficult to pronounce. "B" was one of his hard sounds and in speaking the sentence: "We expect to leave Baltimore," he would say: "We expect to leave ah—ah—ah—Baltimore."

The fear of failure which caused him to acquire this habit of speaking, led his friends often to think that his mind wandered, although as a matter of fact, he was a very bright young fellow, without a single indication of Thought Lapse.

I diagnosed his case as Combined Stammering and Stuttering, and explained to him that he represented a type of stammering that might be called the "Prefix Stammerer" because of their habit of prefixing every hard sound with an easy word or an easy sound, even to the extent of losing the sense of the sentence—so great is the "Prefix Stammerer's" fear of failure.

He placed himself for treatment, and although his trouble was complicated by this prefixing habit, seven weeks put him in good shape. He forgot his fear of failure, found every word an easy word and every sound an easy sound. He learned to talk fluently again and returned to his home, both physically and mentally improved.

Case No. 98.656—This was the case of a rather arrogant young man from a good family, who was too proud to admit that he was a stammerer. Rather it should be said, he was too foolish to admit it. He was well-educated and with the store of words at his command, succeeded for some years in concealing the fact that he stammered. This he accomplished by the substitution of words. That is, words beginning with those letters that he could not utter were not used. If his sentence included such a word, he quickly substituted another word of somewhat similar meaning, but beginning with a letter that he could pronounce correctly. This substitution of words was so well done that for some time it was scarcely noticeable to the average listener. Often he found himself incorrectly understood, because of his inability to use the right word in the right place, but nevertheless he was successful in concealing his speech defect from many of his friends.

This case is of a type known as the "Synonym Stammerer" because synonyms are used to avoid stammering. The mental strain of trying always to substitute easy words for hard ones, was very great, however, and after a few years' practice, the strain began to tell on the young man. It affected his health and made him nervous and irritable.