The common causes of disturbance in the production of voice tone do not seem to account satisfactorily for the case that is here reported. This article attempts to describe a form of atonic and "asynergic" dysphonia possessing characteristic peculiarities of its own, but similar to those in a case I published in a previous paper.1
REPORT OF CASE
History.
—C. S., a farmer, aged 38, complained of difficulty of speech that had existed for three years. Previous to six years before, the patient had been well. At that time he had the "flu," with fever, sore throat, headache and malaise, and he saw double for about ten days. After this brief illness he resumed work without unusual difficulty. About three years before examination, he experienced a slowness of speech which became progressively worse, and he began to suffer with insomnia. About one year prior to examination, his finger and