This difficulty is an inability to pronounce letters properly. This is sometimes the result of defects in the organs of speech, such as cleft palate, paralysis of the soft palate, tongue-tie and other deformities of the tongue, hare-lip, deformity of the teeth, etc. Enlarged tonsils may also be included among the causes of stammering. The difficulty is also not infrequently acquired. It naturally exists in children, in whom, as well as in cases in which the difficulty is very considerable, it is termed "lalling" A very frequent cause of the acquirement of this form of defective speech, is talking "baby talk" to children, and thus preventing them from forming correct habits of articulation. The defects of articulation shown in the speech of children should never be imitated by their attendants. Great pains should always be taken to speak to them in clear and distinct tones, so that they may be led to form correct habits o utterance. This is very important, since it is impossible for most adults to utter many sounds which are not learned during early life, even though they might have been acquired at that time. The learned Kussmaul remarks that "no living man is able to pronounce the speech sounds of all the nations of the earth. A Lepsius may succeed in expressing them in letters, and a Bruecke may unravel the mechanism of their articulation, but it is beyond the power of even such erudite philologists to articulate them all." There is a great difference in the number of sounds possessed by different languages; for instance, the number of consonant sounds in Hindostanee is forty-eight, more than double the number in the English language, which is but twenty. The Greek language contains but seventeen consonants, and some Australian languages are said to have but eight. Some languages are entirely wanting in whole classes of sounds; for instance, the languages of the Mohawks, Senecas, Hurons, and of a number of other Indian tribes, do not contain the sounds p, b,f,v, w, and m, and consequently have not the words "mamma" and "papa," found in almost all other known languages. According to Tylor, when the attempt was made to teach the Mohawks to pronounce words containing these letters, they declared that they would not make themselves ridiculous by attempting to speak with their mouths closed. This peculiarity of different languages is the occasion of the difficulty often met with by persons of different nations in attempting to learn the pronunciation of other languages; for example, the Chinese, having no r, in the attempt to pronounce the word "America," substitute an l for the r, and render it "Ja-ma-li-ka." The German language abounds in gutteral sounds, the French in nasal vowels, the Russian in hissing sounds, such as tsch and even schtsch. In Africa, tribes are found whose language abounds in clicking sounds, and certain tribes of Indians delight in the expression of grunting, gurgling, and chuckling sounds.

The Treatment of Stammering

The treatment for stammering consists in the performance of a proper surgical operation, in cases in which the difficulty can be remedied in this way, and proper training when the difficulty is due to acquired habit.