Handicaps of Childhood

by H. Addington Bruce

THERE lies convenient to my hand at this moment a thin, pamphlet-like volume that tells the story of one of the strangest, among the many singular and tragic blunders which medical science has made in its progress to knowledge. It is a translation from the German of Doctor J. F. Dieffenbach's "Memoir on the Radical Cure of Stuttering." Assuredly, Dieffenbach's "cure" was radical enough, for it consisted in nothing less than the excision of a large, wedge-shaped section from the stammerer's tongue! In this little book, published in 1841, and embellished with several ghastly full-page engravings, is described, with great professional gusto, the first of these terrible operations as performed, without the merciful aid of any anesthetic, on an unhappy boy of thirteen. The result was a "complete success." Says Dieffenbach, writing a few weeks after the operation:

"At the present time not the slightest trace of stuttering remains, not the slightest vibration of the muscles of the face, not the most inconsiderable play of the lips. His speech is, throughout, well toned, even, and flowing."

Thus was inaugurated a period of butchery that lasted until—almost before the year was out—it was observed that those "cured" by this sanguinary means usually began, before long, to stammer as badly as ever, and also that those who were not "cured" had a tendency to die. Yet Dieffenbach was no charlatan, no "quack." He was a reputable surgeon who honestly believed that he had discovered the true remedy for stammering. And, if the passage of time has intensified the tragedy and absurdity of his method and has relegated his glowing account of it to a place in the literature of medical curiosities, there is this to be said of him—that he has had plenty of successors who have erred almost as seriously in their attempts to solve the problem presented by the widespread and baffling malady of stammering.

In fact, up to within quite recent times the record of the struggle against stammering has been one of continuous failure. There has been a steady accumulation of methods of treatment, from surgical operations of a less drastic type than Dieffenbach's to the use of various articulatory and respiratory exercises and devices, without any appreciable effect in the diminution of stammering. Even to-day the great majority of physicians and lay specialists—to whom, by a sort of tacit agreement, the medical profession has largely relinquished the task of dealing with stammering—labour to next to no purpose. At this very moment there are in the United States at least three hundred thousand persons who stammer, fully half of whom stammer so badly that they are severely handicapped in the gaining of a livelihood. Thousands of these have resorted to medical advice, or have attended so-called schools for stammerers, with lastingly beneficial results to few. Small wonder that there is, among stammerers and their friends, a tendency to believe that stammering is one of the hopelessly incurable maladies of mankind.

And this would undeniably appear to be true, as regards many stammerers. On the other hand, it may confidently be said that nearly all cases of stammering are actually susceptible of marked improvement, often amounting to 75 or 90 per cent. of a cure; and that a number of cases can be completely cured. Such a statement, to be sure, could not have been safely made even a few years ago. This for the reason that only lately has there been any really systematic effort by scientifically trained investigators to study the phenomena of stammering, with a view to ascertaining, with scientific exactness, its true nature and causation.

Stammering, it has long been recognised, is not a malady of uniform symptomatology, like tuberculosis or typhoid fever. No two stammerers stammer precisely alike. They stumble over different letters and sounds; time, place, and circumstances have varying effects on the degree of their stammering; and the physical spasms and contortions that so often accompany this trouble differ in different stammerers. There is, too, a great variation in the onset of stammering. Mostly, it is true, it manifests itself in childhood, from the age of four to eleven. But it may not set in until much later in life; and, when it does begin in childhood, it begins under much diversity of conditions.

Sometimes a child stammers almost as soon as he has learned to speak, though seldom, if ever, coincident with the learning. Often, the first appearance of stammering follows some disease like measles or diphtheria. Or, again, a child who has been speaking quite well, suddenly begins to stammer, and persists in stammering, after being brought into contact with people who are themselves stammerers.

"I was entirely free of stammering," declares a clergyman, in a typical statement, "till I was five years old. At that time of life there was a gentleman who occasionally came to my father's house, and stammered very badly. I distinctly remember one afternoon trying to imitate him; when, unfortunately, he heard me, and was very indignant. So ashamed were my parents at my conduct that, after he had gone, I was taken to task and punished severely for it. Ever since that night I have been afflicted with this most distressing malady, in spite of all my efforts to overcome it."

Compare a statement by a Philadelphia physician, Doctor D. Braden Kyle:

"Several years ago I saw three interesting cases of stammering. Two of the cases were imitation. These two lads, who were associated with a boy several years older, the worst stammerer I ever saw, clearly imitated him. As they were constantly together, the imitation was almost continuous. They certainly developed into expert stammerers. In less than two years they were confirmed stammerers, and it was impossible for them to speak at all without stuttering and stammering."