For this reason we think it preferable to exclude stammering,
stuttering, and all defects of phonation or articulation whose existence
is revealed only in the act of speaking. At the same time reference must
be made to facts linking these functional anomalies to the tics, and to
instances of the latter existing with or succeeding the former.
Such is the case with stammering.
According to Letulle,[118] stammering is a tic of speech whose beginning
is a functional disturbance of nervous centres, as is that of tics in
general. Holding as we do, however, that one of the features of tic is
its appearance in season and out of season, we cannot class stammering
as a tic, since its exhibition is restricted to the exercise of a
certain function, viz. speech. It is therefore comparable to a
"professional cramp," and we may briefly note the analogies it offers to
the tics.
Stammering,[119] which in more than fifty per cent. of cases is
hereditary, and associated with a neuropathic diathesis, usually betrays
itself in childhood and becomes aggravated at puberty. The old idea
which credited stammerers with exceptional intellectual powers, in whom,
however, rapidity of thought surpassed rapidity of action on the part of
the muscles of articulation, is exploded, and to-day those thus
afflicted are assigned their true place among the volitionally infirm.
In a few rare cases stammering has been due to organic disease of the
centres for articulate speech, or of bulbo-pontine nuclei; it has been
supposed also to result from genuine spasm on a reflex arc, and this is
a possible explanation; as a general rule, however, the pathogeny of
stammering is identical with that of tic. Its dependence on such
affections of nose, larynx, and pharynx as hypertrophic rhinitis and
adenoids has been emphasised by Biaggi[120]; and Derevoge,[121] in
directing attention to the association of volitional enfeeblement with
respiratory troubles, remarks that stammerers sometimes have a phobia
for certain words. Many observers have been convinced of the psychical
nature of the affection from the fact of its disappearance during
singing, as well as from the effect anger, elation, and other stimuli
have in momentarily inhibiting it. The same is of course true of the
tics.
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