Another recent case is that of a medical student who had repeatedly failed at his viva-voce examination, not, he said, from want of knowledge, but from a mental confusion which seemed complementary to the physical difficulty of speaking the necessary words. All his attention was required for the mechanical work of articulation, and he could give none to the subject-matter. Probably the stammerer is often handicapped in this way, and I think the remedy is, if possible, to bring about a natural automatism in speaking. The mistake made in many systems is that the attention is more than ever directed to the weak spot, and morbid self-consciousness, which is such a prominent feature in stammering, is thereby increased.

I always try to impress upon stammerers that clear and easy articulation is a natural act, and should come spontaneously. It is like walking. If one tries to walk elegantly and pick one's steps, the result is probably a very halting performance, and it is often the same in speaking.

I have observed a great many patients who have been under the treatment of different professors of voice production and elocution. They have been given elaborate exercises, and have probably benefited as long as they carried out the rules laid down, and continued under the eye of the master. But return to the normal conditions of life has generally brought about a relapse. One of the worst cases of stammering I ever heard was that of a young Cambridge man who had for six months been the show pupil of a voice specialist.

These systems attack the periphery instead of the centre, and I am afraid only rarely cure the patient.

It is interesting to note that these views are shared by Mr. Appelt, a professional but non-medical voice specialist. He attaches great importance to the psychic and nervous element in stammering, and treats his cases by a modified psycho-analytic method. *

Dr. Forbes Winslow claims to cure many cases by transfer. I have only tried this method once. The patient was a young undergraduate, with a very bad stammer. He was not a good hypnotic subject, and suggestion had done him no good. So I hypnotized my friend G------, a rather distinguished wrangler, who is a somnambule, in his presence, and told him to take on the stammer, and imitate the patient's speech exactly.

When I awakened Mr. G------he acted the part beautifully, and I impressed upon the patient that his burden was being borne by my friend, and that he was relieved of it. It was certainly a strong appeal to the imagination, but it didn't work; and I found myself with two bad stammerers instead of only one, until I rehypnotized G-----and restored him to normal speech.

* ' Stammering and its Permanent Cure,' by A. Appelt. 1910.

Dr. Wingfield is very successful in his treatment of stammering by hypnotic suggestion, and he tells me he has sometimes succeeded in curing cases of long standing in a few sittings. He has cured six cases out of twelve, some of them very bad ones. *

A bad stammer is a terrible handicap in the battle of life, and any means of curing it should be welcomed as a boon. I think hypnotic suggestion is the most hopeful remedy in the case of young adults, and that it will generally succeed in curing children if systematically employed before the habit has become fixed and permanent.

In the summer of 1905 I was asked to test the value of hypnotic treatment on five Board-school girls, of ages varying from nine to thirteen. Of these, one child proved insusceptible after repeated trials, and one became somnambulic. The other three were influenced to the third degree (Liebeault). The somnambulic child happened to be the simplest case, and was completely cured in a few-sittings. One of the other children had such a bad stammer as to be almost unintelligible, and she was little, if at all, benefited. The other two improved considerably under treatment, and would, I think, have been cured if it had been possible to give them lessons in proper voice production at the same time as the hypnotic suggestion. †

If it is of importance, in some cases, to transfer normal actions from the domain of excessive consciousness to that of subconsciousness, it is no less important, on the other hand, to be able at times to reverse the process, and to bring morbid actions which have become automatic under the direct action of the will. Nail-biting is an example of what I mean. Here the habit has become automatic and unconscious, so the child puts his hands to his mouth and destroys his nails without knowing it, until perhaps he has gnawed them to the quick, and is rendered conscious of his act by the pain. Acting on Berillon's advice, I have in treating these cases by suggestion made it my aim to bring these unconscious morbid actions into the sphere of consciousness, and establish, as it were, a fence of inhibitory suggestions to protect the threatened part. The child is told that in future, when he moves his hand to the mouth to bite his nails, he will feel a heaviness in his arm and shoulder and a tingling in the fingers, which will continue until he calls his conscious will into play and checks the impulse. An inhibitory centre is thus educated; and I have found this treatment successful in a number of cases, not only of nail-biting, but of other bad habits.

The same principle is sometimes acted upon in the treatment of drunkards. The patient is told that if he attempts to raise a glass of spirits to his lips, his arm will become paralyzed, and he will drop the glass.

* Op. cit., p. 148.

† Our object in undertaking these cases was entirely in the interest of truthful investigation, and at the close of the treatment we wrote to the teachers and parents asking them if they found the children benefited. The parents evidently thought that we sought testimonials for advertising purposes, for they supplied most glowing ones, even concerning the poor child who had derived no appreciable benefit. This good-natured facility showed us how easily such testimonials are manufactured.