His voice was thick, and he spoke with an effort.

She gasped in a breath, and spoke with an effort.

She spoke with an effort, as though she were trying to convince herself.

Jubal nodded, then he spoke suddenly, as if with an effort.

Fresh sweat glistened on his face, and he spoke with an effort.

You have to speak it, with a conscious effort, like a spell or imprecation.

Thanks, he thought, refraining from speaking aloud with a savage effort.

Then he spoke with an effort and said, softly: "A very great lady."

After a few moments he spoke with an effort.

Then he began to speak, slowly, with an effort of memory and several pauses.