Good morning. You sure have had a lot of visits with me this past while. Is the NFL covering your co-pay or something? At any rate, time to look at your chart… you’re saying that you’ve been at a loss for words since football season ended? I suppose, in some ways, many of us have experienced the same. But perhaps it’s all that peanut butter you’ve been eating that’s been causing this? No? Well, I’m going to have you to open your mouth wide and say “ahh”, please.

THE HEMIGLOSSECTOMY: A SURGICAL METHOD FOR THE ELOQUENT ORATOR?

What are the positives of this treatment?

It’s tough to be a stutterer. Since the dawn of human speech hundreds of thousands of years ago, impediments to clear communication have run rampant, causing all kinds of ill effects – but especially embarrassment to the stutterer. Still, against all odds, stutterers have still risen to the upper echelons of society – from England’s King George VI to esteemed actor James Earl Jones to US President Joe Biden, just to name a few. It is probably fair to say that it has become much more manageable to be a stutterer in the modern era, especially with advancements in speech therapy and other early intervention, non-surgical techniques.

It wasn’t always this way, of course. In 1840s Prussia, Dr. Johann Friedrich Dieffenbach was a highly regarded surgeon, best known for his pioneering research on blood transfusions, as well as many new discoveries in the field of craniomaxillofacial surgery. Dr. Dieffenbach was a continental leader in skin grafts and transplants, and even managed to surgically treat a boy with strabismus – i.e., a lazy eye – in the early 19th century – a remarkable feat.

Dr. Dieffenbach also pioneered a stuttering treatment for those suffering from the affliction. To our Prussian doctor, stuttering was due to overstimulation of the nerves in the tongue that controlled speech, and thus a surgical correction was both appropriate and effective. Called the hemiglossectomy, the procedure involved cutting out a triangular-shaped wedge close to the root of the tongue, killing the apparent offending nerves and stopping the stuttering!

And it definitely did stop the stuttering.

What are the negatives of this treatment?

As one might imagine, not only was the stuttering stopped… but so was much of regular speech as well. Many patients were left completely mute by this technique, as the surgery severed so many nerves in the tongue that it meant patients had essentially zero control of it afterwards. Not only was speech an impossibility for most, but even just  keeping the tongue inside their own mouths was a real struggle.

Not only was the technique overly zealous, but we also have to remember that the procedure was, like so many others of its day, done completely without the use of any anesthetic. One can guess at how that went over among 19th-century patients.

What are are some real life examples of this treatment? 

Around the same time as Dieffenbach’s work in Prussia, a French physician by the name of Chegoin tried a similar surgical technique; he believed that stuttering was caused by an unbalanced ratio of tongue to oral cavity. Only by reducing the size of the tongue would the stuttering be cured… it’s believed this method was similarly successful to the German method.

The traditional Prussian hemiglossectomy is no longer performed as a stuttering treatment thanks to advances in speech therapy and psychiatry, both of which have proven to have much more positive effects, especially when used jointly and when applied from a very young age with patients. That said, hemiglossectomies – and full glossectomies – are still occasionally used today, most predominantly for instances of extremely advanced oral cancer. Rather than a triangular incision at the base of the tongue, more modern procedures simply remove the cancerous areas of the tongue, which, for some, can unfortunately be quite large.

It is curious to some that surgery was considered, for a brief time, the go-to treatment method for this incredibly common problem – particularly when so many other interventions have existed throughout history.

The famous Greek politician and orator Demosthenes received treatment for his terrible stutter from an actor named Satyrus. According to written records from Plutarch, Satyrus trained Demosthenes in a number of brilliant solutions; he improved his breath and energy by practising his speeches by walking uphill, using a mirror to watch his lips, jaw, and tongue, and to stop switching his Rs into Ls by making him speak with a mouthful of pebbles.

Another 19th-century French surgeon named J.M.G. Itard used a golden or ivory fork, placed in the oral cavity, to support the base of the tongue and prevent stuttering… although more humane, it’s unclear as to whether it was any more effective.

An American doctor named Yates had an additional method for treating stuttering which became quite popular in Belgium and Prussia later in the 19th century, though, once again, the efficacy of said treatment is entirely unclear. He emphasized in his experiments that stutterers should speak every word with their tongue raised to the roof their mouth, and pushing every sound forward towards the front of their lips.

How can we improve this treatment for the future?

The use of surgery as a stuttering relief method was innovative, if ill-informed; I believe it’s a reasonable possibility that with a revision of the surgical process, one could potentially see improvements in the modern era. Consider the possibility of looking like the subject below:

In a worst-case scenario, the stuttering will be resolved, largely in part because nearby people will no longer ask to hear the person speak at all!

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Information for this article taken from here, here, here, here, here, here, here, here, and here.