Staeimerlig, a term generally applied to all kinds of defective utterance, but more correctly restricted to the organic or symptomatic defects, in distinction from stuttering, which is properly an idiopathic or functional difficulty. Both stammering and stuttering may nevertheless be treated under the common title. The causes which lead to stammering-are usually, though not always, organic; harelip, cleft palate, elongation of the uvula, enlargement of the tonsils, a deficiency or unusual position of the teeth, tumors of the tongue or cavity of the mouth, and inflammation or ulceration of the parotid glands, are the most frequent of these causes. Where the defect results from functional disturbance, its principal causes are general debility, paralysis either local or general, tetanic or other spasms; a rheumatic or neuralgic affection of the muscles of the face, jaw, tongue, lips, etc, or of the vocal cords; a condition of intoxication; chorea; or in some cases a habitual imitation of stammering. Occasional stammering may be produced by a temporary confusion of mind, without any anatomical defect of the vocal organs. Stuttering is seldom or never organic. The stutterer is often in perfect health, and the vocal organs are not in any way diseased or deformed.

His difficulty consists in the momentary inability to pronounce certain words or syllables. The stoppage of sound usually takes place at the first syllable, though occasionally at the second or third. Words beginning with k, t, g, d, p, b, or m usually give the stutterer the most trouble, because they require the closing of the lips or the pressing of the tongue against the roof of the mouth for their enunciation, and an immediate reopening for the vowel which follows; while he keeps the lips closed, and compresses the cavity of the mouth in the attempt to force out the sound. Most stutterers can sing without difficulty, the action of the vocal organs being much less frequently interrupted in singing than in speaking. Stutterers may be classed under two heads, mental or psychical and physical. Under the stimulus of pleasant or joyful emotions, the first class experience little difficulty in conversation; under depressing influences, their utterance is seriously disturbed. The physical stutterer is rendered worse by unpleasant weather, great fatigue, vicious indulgence, and the excessive use of tobacco or alcoholic drinks.

The number of bad stammerers is estimated by Colom-bat at 1 in 5,000; but the number having some degree of impediment is not probably less than 1 in 500. Only about one tenth of these are females. - The proper treatment of either stuttering or stammering is indicated by the cause which induces it. In the case of the stammerer there should be a thorough investigation for an organic cause. The clipping of the uvula, the removal of a portion of the tonsils, or the excision of a wedge-shaped piece from a tongue too large for the mouth, the use of electrical or other remedies for the cure of paralysis, the cauterization of ulcers in the mouth, the removal of irregular or the insertion of false teeth, and the administration of tonics for debility, have each resulted in the cure of cases of stammering; but no one of these will answer for all or perhaps a majority of cases. In stuttering also, the cause will indicate to some extent the method of cure. The muscles must be educated to uniform obedience to the will, and the will trained to steady and intelligent control over the muscles and nerves. A course of lessons in enunciation, by a capable teacher, will often effect a complete cure.

Dr. J. M. Warren of Boston lays down the rules that treatment for impediments of speech should be commenced between the ages of 8 and 12; and that "little permanent advantage will be gained, in the majority of cases, unless the treatment be resolutely persevered in for one or two years".