Dysphasia or difficult speech is to be distinguished from aphasia or absent speech. As a rule, dysphasia means difficulties that are central in origin as distinguished from those caused by peripheral lesions, such as difficulty in moving the jaw (dysarthia) or laryngeal disease (dysphonia).
Under the term dysphasia would be classified both stammering and stuttering. I have never encountered either of these difficulties in Little's disease and therefore I will not discuss them. In patients with cortical injuries, I have observed two types of disability: (1) difficulty in making certain sounds, for instance, sw in "sweet," or in giving the rough sound to a vowel, such as h in "hello"; (2) difficulty in slipping rapidly and easily from syllable to syllable. The latter disability may be obvious when the second sound is a repetition of the first, as in "mama"; but it is much more likely to be enhanced when