The historical roots of the theory and therapy of stuttering

Abstract

The history of the problem of stuttering, one of the best known yet least understood disorders of communication, begins with several brief mentions of ‘ ‘truuloi’ ’ by Hippocrates (460-377 B . C. ) . Although we can be sure that this word refers to a speech defect of some kind (it is very’likely a generic term that would today be regarded as several distinct defects), its exact meaning is far from clear. Particularly in the books of the Epidemics, the passages are quite obscure, as their definitive commentator, Galen (13 l-ca 200 A.D.), readily admitted. This did not stop him from making some kind of sense of them, however. Since the subsequent history of the subject is largely derived from these Galenic commentaries, at least up to the beginnings of the scientific revolution of the seventeenth century, a few general remarks would be in order. In the first place it is impossible to understand the earlier history of stuttering unless we realize that no basic distinction was made between stuttering, cluttering, disarthria, functional articulation problems, and even some types of aphasia. Secondly, as a corollary to this, the terminology for these various conditions was anything but precise. We find each of the terms traulosis, psellismos, blaesitas, balbuties, and to some extent mogilalia, used to describe every one of these conditions, while ischnophonia, which very clearly means stuttering in the works of Aristotle, just as clearly describes a weak voice in the works of Galen. Thirdly, the humoral system of medicine, which Galen espoused, and which became the framework of medieval and renaissance medicine, made no diagnostic disjunction between mind and body. For this reason it is somewhat misleading to think in terms of a “humoral physiology” and a “humoral psychology” (useful as these concepts may be in tracing the development of the respective modern disciplines of those names), because no real separation appeared until the humoral system was already in an advanced state of decay. With the lack of such clear distinctions, the Galenic writings on stuttering at first appear almost totally worthless to the modern investigator. Their meaning