ity may be due to a cleft palate, or to some less grave defect which prevents insufficient contact between the soft palate and the back wall of the pharynx. Various other noises emanate from the mouth and nose, accompanying certain unusual and mainly involuntary forms of respiration. These are classified by Yon Meyer, from whose "Organs of Speech," in the "International Scientific Series," most of the material for this article has been obtained, as disturbances of inspiration, to which class belong hiccough, gaping, and stammering, and disturbances of expiration, under which he enumerates sneezing, coughing, laughing, and sighing.
Hiccough is the simplest of the former class, and is merely a violent inspiration caused by a convulsive contraction of the diaphragm. The ensuing expiration then takes place quietly. The air inhaled may enter principally either through the mouth or the nose, or through both equally, and in each case the accompanying noise is different. A contraction of the glottis may also take place at the same time, and in this case the entering stream of air creates, in passing between the vocal chords, a sharp, clear tone. During an attack, one inspiration in about four or five is convulsive. Hiccough arises from over-irritation of the nerves of the diaphragm, the cause of which we know to be either psychical conditions or overfilling of the stomach. When the stomach is overladen with food or with effervescing or alcoholic drinks, it resists to a greater or less extent the fall of the diaphragm; the contractions of the diaphragm necessarily become more labored, and occasionally, like other over-irritated muscles, assume a convulsive character. Frequently, however, the hiccough appears as a sign of the general over-irritation of the nervous system in hysteria, and, probably from the same reason, it may not uncommonly be observed in otherwise healthy young persons, particularly children. The above explanation of hiccough as a convulsive contraction of the diaphragm is further confirmed by the manner in which it may be stopped. It is, namely, only necessary to allow an exceedingly protracted and, at the end, forcible expiration to follow a long and quiet inspiration. The slow inspiration, especially when it is chiefly performed by the wall of the chest, prevents the phrenic nerve from being too powerfully irritated, while the long expiration gives this nerve time to recover from its over-irritation. A remedy which the writer has tested many times without a failure can always be used upon a person who has "the hiccoughs" by some one else, and generally by the sufferer himself. You say to your friend something like this: "See how close together you can hold the tips of your forefingers without their touching. No, keep your elbows out free from your sides. You can get your fingers closer than that. They are touching now. There, now hold them so. Steady." By this time you can generally ask, "Now, why don't you hiccough?" The involuntary tendency to breathe slowly and steadily when the attention is fixed on performing a deli-
