Popular Science Monthly/Volume 3/September 1873/Tongueless Speech
By W. J. YOUMANS, M. D.
MANY animals possess the attribute of voice, but man is the only one among them all capable of modulating voice into speech. This he does by changing the shape of the cavities of the throat, mouth, and nose, by the actions of the muscles which move the walls of those parts, and by the movements of the tongue. The latter organ is commonly credited with the most important share of the work; a distinction to which, as we shall soon see, it is far from being entitled.
The sounds of the vowels, in ordinary speech, are produced by a continuous expiration, the mouth being kept open, and the form of its aperture changing with the utterance of each. Certain consonants may also be pronounced, without interrupting the current of expired air, by alterations in the shape of the throat and mouth: h, for example, is the result of a little extra expiratory force; s, z, sh, and j in some cases, th, l, r, f, and v, may likewise all be produced by continuous currents of air forced through the mouth, the shape of the cavity of which is peculiarly modified by the tongue and lips. All the other consonantal sounds of the English language involve the blocking of the air-current in its passage through the mouth. In the case of m and n, it is prevented from issuing through the lips, and is forced through the nose; while the remaining consonants, termed explosives, such as b and p, are produced by shutting the passage in both mouth and nose, and forcing the vocal current through the obstacle furnished by the mouth, changes in the form of which give to each consonant its peculiarity.
This, in brief, is the explanation given by Huxley, of the formation of articulate sounds; and it will be seen that, while the tongue is intimately concerned in modifying the shape of the oral cavity, only a few of the sounds, such as those of d, t, s, sh, l, and r, and sometimes g, require its presence, and most of these even may be approximately sounded without it. In his "Elementary Lessons in Physiology,", Prof. Huxley relates the case of a man, examined by him, whose tongue had been removed as completely as a skilful surgeon could perform the operation, two inches and a half of the member having thus been lost. The stump could be seen occupying a position as far back as the anterior pillars of the fauces, forward of which point, when the mouth was open, it could not be advanced. Yet this person could talk with little apparent difficulty, giving most of the sounds with ease: s and sh, l, and r, and final g' s, were more or less imperfect, but d and t were the only ones completely beyond his power. Well-authenticated cases of a similar character have, from time to time, been recorded; a few of the more remarkable of which are given in the following pages.
Cutting out the tongue was a form of punishment frequently inflicted in ancient times. In a. d. 484, sixty Christian confessors of Tipasa, a maritime colony on the north coast of Africa, had their tongues cut out by order of Hunneric, the Vandal conqueror; but, in a short time, some of them at least were able to speak with such distinctness that they went about preaching again. Pope Leo III. is said to have suffered a similar mutilation in 799, and afterward regained his speech. In the sixteenth century, a band of French Protestants were condemned to have their tongues cut out before they were led to the stake. One of them, immediately after the execution of the sentence, repeated three times, "Le nom de Dieu soit béni!" (God's name be blessed). In another case, the martyrs spoke so distinctly after losing the tongue, that the executioner was accused of having failed to carry out the sentence.
The ability to speak, after being thus deprived of the tongue, was long accounted miraculous, and regarded as a signal mark of divine favor. Even as late as the present generation this view of the matter has been maintained, in spite of the fact that the accumulated experience of surgeons has demonstrated it to be an entirely natural result, with nothing miraculous about it.
Sir John Malcolm, writing from Persia in 1828, describes the case of a chief named Zâl Khan, who, coming into disfavor with the reigning monarch, was condemned to have his eyes put out. Failing in his appeal for a recall of this cruel sentence, Zal Kahn "loaded the tyrant with curses," and, in return, his tongue was ordered to be cut out. This order was imperfectly executed, and the loss of half the member is reported to have deprived him of speech. Being afterward persuaded that, if cut close, he might be able to speak intelligently with the root, he submitted to the operation, and subsequently told his own story to Malcolm. These statements were long doubted, but, in 1857, they were fully confirmed by Sir John McNeill, whose inquiries in Persia, where this mode of punishment is common, led to the discovery of many instances of a similar nature. The belief is universal in that country, that excision of the tip of the tongue permanently destroys the power of speech, while its removal at or near the root leaves the victim a chance of regaining the ability to again speak his mind. Surgeons are agreed, however, that, for the purposes of talking, the more there is left of the "unruly member" the better.
But, even after total extirpation of the tongue, persons have been known to retain the faculty of speech without serious impairment. A case of this character is related by Roland, surgeon to the French court in 1630. It is that of a boy who lost his tongue, when six years old, from gangrene, the result of an attack of small-pox. At the time he came under observation, three years later, all that remained of the organ was a slight, double prominence, flattened and attached to the floor of the mouth, extending from the inside of the chin to the oval aperture of the throat. This was composed of muscular tissue, divided by a line, and was like two little muscles, with a furrow between them. When it was pressed, or when the child spoke or swallowed, it swelled, gathered itself up, and retracted from side to side toward its middle, or from one side of the mouth to the other, like two leeches joined together. Roland believed these small bodies to be the remains of some of the muscles ordinarily employed in the movements of the tongue. This child's mouth was anomalous in other respects. The palate was considerably flattened, and the teeth were in a double row, the outer row being the milk-teeth, which had not been shed, and the inner row the permanent teeth, which had come up behind, and pointed inward. Both these conditions the French surgeon attributed to the absence of the tongue, which, by its upward pressure, tends to produce the concavity of the palate, and, by its forward pressure, to force the teeth into a vertical position. The entrance to the pharynx was of an oval shape, and unusually small. The uvula was long and thin, descending almost to the epiglottis, and the tonsils were as large as chestnuts. Notwithstanding the almost complete absence of any thing answering to a tongue, and the additional defects enumerated, the child was able to speak intelligibly. Bonami and Aurran have recorded similar cases in the "Memoirs of the French Academy of Chirurgery."
A still more remarkable example of the retention of the powers of utterance, after loss of the tongue, is that of Margaret Cutting, whose case was brought before the Royal Society of England in 1742, and again in 1747. This girl lost her tongue by what was supposed to be a cancer, when four years old. The disease first appeared in the shape of a small black speck on the upper surface of the tongue, and rapidly eat its way quite back to the root. One day, while the surgeon who had the case in charge was syringing the parts, the tongue dropped out, the girl immediately thereafter, to the great astonishment of those present, saying to her mother: "Don't be frightened, mamma; it will grow again." Three months afterward it was completely healed, with not a vestige of the tongue remaining. At the age of twenty this girl was carefully examined by several competent gentlemen, who report in the 44th volume of the "Philosophical Transactions" as follows, regarding her condition: "We proceeded to examine her mouth with the greatest exactness we could, but found not the least appearance of any remaining part of the tongue, nor was there any uvula. . . . . Notwithstanding the want of so necessary an organ as the tongue was generally supposed to be, to form a great part of our speech, and likewise to be assisting in deglutition, to our great admiration she performed the office of deglutition, both in swallowing solids and fluids, as well as we could, and in the same manner. And as to speech, she discoursed as fluently and as well as others do. . . . She read to us in a book very distinctly and plain, only we observed that sometimes she pronounced words ending in ath as et, end as emb, ad as eib; but it required a nice and strict attention to observe even this difference of sound. She sings very prettily, and pronounces her words in singing as is common."
The inability to speak, after loss or mutilation of the tongue, is sometimes due, not so much to the lack of that organ, as to the state of the sufferer's mind. Like those patients with impaired locomotive powers who, believing they cannot walk, seem to lose the power of will necessary to enable them to try to walk, the person with an imperfect tongue, laboring under the impression that talking is impossible, fails to make the necessary effort, and perhaps would never regain the faculty of speech unless startled into some involuntary exclamation that convinces him of his mistake. An amusing example of this accidental recovery of speech is quoted by Dr. W. Fairlie Clarke from the works of Paré. A rustic who had lost a portion of his tongue, and believed he could not speak, was tickled by a companion while he was in the act of drinking, when, in spite of his mental impression, words burst forth. "He attributed this to the use of the basin that he was holding to his lips; and, having by its means regained faith in his powers of utterance, he always carried a basin about with him, and applied it to his mouth when he wished to speak. . . . The effect of a nervous shock," says Dr. Clarke, "is distinctly seen in a case recorded by the celebrated Dr. Tulp, of a young man sailing in Italy, who was taken by pirates, and carried to Turkey. On account of his refusal to turn Mohammedan, his tongue was cut out. He was dumb for three years, but recovered his speech suddenly one stormy night, when he was terrified by a vivid flash of lightning which was followed by a loud peal of thunder."
In the cases thus far cited, speech was fully developed before loss or mutilation of the tongue occurred, and the other organs, having become perfectly educated, were subsequently able to assume and carry on the function. What is more remarkable still, not only can the tongue be spared after the power of speech has been perfected, but it appears to be quite unnecessary to the development of the faculty. This is shown by a case described by M. de Jussieu, the more interesting parts of whose narrative are given by Clarke, in his work on the "Diseases of the Tongue." The subject was a girl, born tongueless, in a village of Alemtejo, a small province of Portugal. The defect was first made known by her inability to suck, a difficulty that the mother obviated by pressing her breasts, and thus forcing the milk to flow into the infant's mouth while it held the nipple tightly between its lips. This girl was fifteen years old when first seen by Jussieu, who, after two careful and thorough examinations, thus describes the condition of her mouth: "I remarked only a small elevation, in the form of a mamelon, which rose in the middle of the mouth to the height of about three or four lines. This elevation would have almost escaped my observation if I had not assured myself of its existence by touch, for it was scarcely visible. In pressing it with my finger, I felt a sort of movement, of contraction and dilatation, which showed that, although the organ of the tongue was absent, yet the muscles which form it, and which are designed to move it, were present; for there was no hollow under the chin, and I could only attribute the alternating movements which I have described to these muscles. . . . Some persons, perhaps, who doubt the possibility of any one speaking without a tongue, may imagine that in the case of this girl it was not really absent; but that by some natural accident it was adherent to the lower or lateral portions of the mouth. But an inspection will at once remove this impression; for not only is its cavity larger than usual, but at the back the uvula is distinctly visible, and is seen to be more than double the usual length, and also a little thicker than ordinary. It stretches almost to the epiglottis, and forms at the back of the throat two equal rounded openings instead of one; while in other subjects the aperture, though single and larger than the two together in this case, can only be seen by pressing down the base of the tongue."
The function of speech was performed by this girl so distinctly and clearly that no one would have known, without being told, that the tongue was absent. She could clearly pronounce all the letters of the alphabet, as well as separate syllables, and complete sentences. It was observed, however, that some of the consonants, such as c, f, g, l, n, r, s, t, x, and z, were pronounced with more difficulty than the other letters, and that, when she had to utter them slowly and separately, the effort required to sound them was shown by bending her head forward, so as to bring her chin nearer to the throat or larynx, thus raising the latter and placing it almost on a level with the teeth.
The Medical Record quotes from the Canada Medical and Surgical Journal, for March of this year, a case of removal of the tongue and lower jaw of a man aged seventy-one years, in order to get rid of a cancerous mass that extensively involved those parts. Four months after the operation he was brought before theMedico-Chirurgical Society of Montreal; no great amount of deformity was observable, and "speech was restored to some extent, notwithstanding the entire ablation of the chief organ which gave it articulate utterance."
"The singular fact," remarks Jussieu, "of a mouth which could speak though it contained no tongue, ought to convince us that the presence of a tongue is not absolutely essential to speech, since there are other organs in the mouth which contribute to produce articulate sounds, and which can supply the lack of it. The uvula, the nares, the palate, the teeth, and the lips, are all so much concerned in speech, that whole nations are distinguished by the manner in which they make more or less use of one or other of these parts."
- Quoted from W. Fairlie Clarke, "On the Diseases of the Tongue."