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The hysterical aphonia was for the first time submitted to psycho-analytical study in one of Freud's classical works, published in 1905, and the phenomenology of the psychogenous disorder of speech occupied since then a rather prominent place in the casuistic of a psycho-analytical clinic. We shall try, in the present article, to complete this casuistic by our own material, being the analysis of a case of most tenacious aphonia, that lasted with interruptions, nearly ten years. The certain originality of our attempt is that besides the usual psychological analysis, we shall study the pathology of case by means of the physiological analysis in the manner of the schools of Pawloff and Ukhtomsky. This endeavour will be based on our previous works, 1 to which the interested are referred.
The preliminary informations, concerning the history of the illness, are as follows:
Mrs. NN., aged 29, applied to me in June 1925, complaining of a periodical disappearance of the voice, that lasted for several years and was always accompanied by a difficult, whispering speech. The laryngologist's diagnosis, produced by the patient, ascertained a weakening of the laryngeal musculature with no objective signs whatever of any derangement of the vocal apparatus.
The primary interrogation made clear, that the patient fell ill for the first time in 1915, after a quite, as it first seems, insignificant shock. She had a quarrel with the manager of the asylum, where she was employed and, on the morning immediately following the dispute, she became completely dumb. The dumbness lasted for nearly a month and then it ceased. In the following years the patient passed through several neuralgias, sexual anæstesia, premature child-birth, stubborn hiccup, fits of drowsiness, reiterated wishes to go to stool, heart neurosis and so forth, till at last, for the first time in 1923, she lost her voice and began to speak with the characteristica whispering sound. Since then the attacks of aphonia appea