Talking with the Gullet

Abstract

THE removal of the larynx is a drastic operation, but the use of sulphonamide and penicillin have made it possible to prevent the sepsis which formerly hindered recovery (Lancet, March 2, p. 312) The operation involves loss of normal speech, and it is good to learn that remarkable progress has been made in teaching people who have lost the larynx to speak with the œsophagus. Speech can be produced by a stream of air which comes up through the œsophagus instead of through the trachea. The subject must first learn to swallow air. It is not essential that he should do this before the operation, but it is better if he does so. A week or so before the larynx is removed, he is taught to close the glottis and the lips and to expand the chest as he swallows, so that air is aspirated ; this can then be brought up again in a noisy belch. When the operation wound has healed, the swallowing of air and belching is resumed. The trick of this may be learned more easily if a boiled sweet is sucked or if the subject takes acid and alkaline powders which give off gas in the stomach. Very soon it becomes possible to convert the belching of wind into something like speech. Consonants such as sh and ch are usually the first to be practised. Vowels are then added to them and words like church and scrub are made. When such explosive consonants as p, d and k have been learnt, other words are added. Before long, several syllables, or one long word, can be spoken with each intake of air, and attempts are then made at short sentences. Pauses for the intake of air cause abnormal grouping of words, and this difficulty is only slowly overcome.