Historic Treatments for Stuttering:
From Pebbles to Psychoanalysis

by Barbara Goldberg

According to the Bible, Moses stuttered. "why me?" Moses asks God when told he has been chosen to lead his people out of bondage. "I am slow of speech and of a slow tongue." The question angers God: "Who hath made man's mouth? or who maketh the dumb, or deaf, or seeing, or the blind? Have not I the Lord?" God answers that Moses' brother Aaron shall be his mouthpiece.

A Talmudic story explains the origin of Moses' stutter: while Moses was still an infant, the Pharaoh was advised to kill him, for one day, it was predicted, Moses would rise up against him. The Pharaoh at first shrugged, then decided to put Moses to the test. He placed two bowls before Moses, one filled with gold, the other, with hot coals. If Moses chose the gold, he would be slain. Of course Moses reached for the gleaming gold, but an angel intervened and struck hi hand. So he grabbed a hot coal and put it in his mouth. And thereafter stuttered.

Demosthenes (383-322 BC) had the good fortune to have Satyrus, the Greek actor, as his speech-language pathologist. Demosthenes not only stuttered, but had a harsh, tuneless voice, and trouble with his r's. Satyrus prescribed voice exercises for him--the use of a mirror, pebbles in the mouth, and declaiming while going uphill were all part of the treatment.

Aetius of Amida (6th century) was royal physician to Justinian at Byzantium. His cure for stuttering was more radical--he blamed the tongue as the cause of stuttering and recommended division of the frenum.

Surgery was a popular treatment for centuries. Johann Frederick Dieffenbach (1795-1847), a German surgeon and professor clinical surgery in Berlin, devised a surgical procedure to treat speech defects that became fashionable in Europe for several years. He made a horizontal section at the root of the tongue, excising a triangular wedge completely across and nearly through it, with the object of dividing the lingual muscles and thereby interrupting their nerve supply in order to modify or cure the muscular spasm. His method was the result of a fancied connection between defective articulation and strabismus.

And in Paris, H. de Chegoin, author of Recherches sur les Causes et le Traitment du Begaiement (1830), believed the tongue to be of disproportionate size in people who stutter. He attempted by "mechanical means" to alter this disproportion.

J.M.G. Itard's treatment was more humane, but no more effective. A surgeon, and later doctor for the Institute for Deaf and Dumb in Paris, he maintained stuttering was caused by muscular debility. He used a golden or ivory fork (know as "Itard's Fork") placed in the cavity of the alveolar arch of the lower jaw for the purpose of supporting the tongue. He reported two cures (Journal Universel des Sciences Medicales, (1817), neither of which were permanent, according to other accounts.

Meanwhile, across the ocean in New York, Yates was inventing "the American Method." He believed stuttering was caused by spasm of the glottis. His treatment was carried out in an institute under the direction of "the widow Leigh," governess of Yates' daughter, this being done to avoid professional disrepute. Another version attributes the method to Mrs. Leigh herself, whose husband had stuttered. The method advocated raising the tip of the tongue to the palate and holding it there while speaking. The secret was bought by Malebouches. He improved her method by advocating elevation of the whole tongue to the palate, and by directing treatment to the lips. Maleouches sold "Mrs. Leigh's Trick" to the Belgian and Prussian governments. Baussmann was made "professor" of the system by the Prussian Ecclesiastical Minister of State.

Charles Canon Kingsley (1819-1875), celebrated English orator, writer, and chaplain to the Queen, had a stuttering problem until he was 40 years old. He believed the cause could be traced to conscious or unconscious imitation. In a letter to a young lady, he tells her she stutters because her upper teeth, like his, shut over the lower ones. He recommended dumbbell exercises to help breathing, and placing a bit of cork between the back teeth when speaking. He thought childhood an unsuitable time for treating the defect and praised boxing as being "over and above a healing art" for the person who stutters.

Moses Mendelssohn (1729-1786) insisted the chief reason for stuttering was psychological, due to a collision between many ideas flowing simultaneously from the brain. Erasmus Darwin (1731-1802), English physician and naturalist, believed emotions such as awe or bashfulness caused interrupted association of the movements of the organs of speech. Joseph Frank (1811) enumerated many causes of stuttering, such as cerebral lesions and sexual excess.

The late 18th century produced a spate of specialists who believed stuttering a neurosis. Psychoanalysis was often the treatment of choice. Sandow (1898) thought each paroxysm of stuttering was induced by psychic stimuli, caused either by dread of speaking or a too violent eagerness to speak. He noted that young children vocalize with fluency only when stimulated by feelings of ease and comfort. Fear and physical discomfort are antagonistic to fluency. Steckel (1908) called stuttering one of the worst forms of fear hysteria and believed stuttering to be as much a psychological betrayal as are slips of the tongue and pen. The neurosis always begins in childhood, generally as a pure anxiety neurosis.

Aristotle, Isaac Newton, Charles Darwin, Clara Barton, Winston Churchill, Marilyn Monroe--this is just a partial list of famous people who stuttered. And a reminder that it is the inner voice that must be attended. --BG

Reference

Klingbeil, G.M. (1939). The historical background of the modern speech clinic. Journal of Speech Disorders, 4, 115-132.


first published in ASHA magazine, June-July 1989, p. 71
added with permission of ASHA
December 28, 2007