Manipulated videos of Speaker Nancy Pelosi that made it seem as if she were repeatedly stumbling and slurring her words spread across social media on Thursday, as tensions escalated between President Trump and the Democratic leader.

One of the videos, which showed Ms. Pelosi speaking at a conference this week, was slowed down to make her speech appear continually garbled. The video has been viewed millions of times on Facebook and was amplified by the president’s personal lawyer, Rudolph W. Giuliani, who shared the video Thursday night on Twitter. “What is wrong with Nancy Pelosi?” Mr. Giuliani said in a tweet that has since been deleted. “Her speech pattern is bizarre.”

Mr. Trump tweeted a separate video of Ms. Pelosi, from Fox Business, which spliced together moments from a 20-minute news conference to emphasize points where she had stumbled on her words. “PELOSI STAMMERS THROUGH NEWS CONFERENCE,” the president tweeted.

The edited videos surfaced online amid a particularly intense and public feud between the two leaders. Each questioned the other’s temperament and mental fitness in an exchange of personal insults on Thursday, as Ms. Pelosi works to stave off impeachment proceedings that she believes could harm her party and as Mr. Trump continues to defy Democratic efforts to subpoena documents and summon witnesses in the wake of the release of the special counsel’s report last month.

But the videos also raised broader concerns about the roles of digital manipulation, misleading videos and misinformation in politics going forward, particularly in the lead-up to the 2020 election.

Mr. Trump has previously used doctored, if obviously cartoonish, videos for political purposes, including ones targeting former Vice President Joseph R. Biden Jr., a Democratic candidate for president, and CNN, the cable news network. In another case, his administration relied on a misleadingly edited video from a contributor to the conspiracy site Infowars to help justify removing the credentials of CNN’s chief White House correspondent, showing how such videos can make their way from the corners of the internet to the mantel of presidential politics.

The origin of the footage that slowed down Ms. Pelosi’s speech was not clear. In a video posted by C-SPAN, she can be seen speaking at normal speed at a conference for the Center for American Progress.

But the edited version was shared widely on Facebook and elsewhere, prompting many to question whether Ms. Pelosi had been drinking or had been otherwise under the influence.

An aide to Ms. Pelosi described the attacks as sexist and said the speaker does not drink. Her supporters also raised concerns about the timing of the president’s own tweet sharing the spliced Fox Business video, which came as the video slowing down her speech was making the rounds online.

On Friday, Facebook said that a third-party fact checker had rated the slowed-down video as “false” and that the company was working to reduce the video’s distribution on its site.

A representative for YouTube said the video violated the site’s policies and had been removed.

On Friday, Mr. Giuliani said that he did not know the video was altered when he shared it on Twitter.

“I didn’t know it was doctored,” he said. “I had no reason to believe it at the time. It looked like enough of an extension of the way she communicates anyway.”

“It did seem a little exaggerated and I think I tweeted, ‘What’s wrong?’” he added. “But to overreact is a little hypocritical given she is the one who was making very, very direct comments about the competence of the president of the United States of America, which I don’t think any good American should do.”

Mr. Giuliani said that he took the tweet down after someone texted him calling the video into question. He said he had not seen the original footage.

“Where do you go to check that it’s inaccurate?” he said. “How could I have figured out that it was inaccurate?”

The back-and-forth between Mr. Trump and Ms. Pelosi ensued on Thursday as she suggested that he was too unstable to govern. The president’s theatrical scrapping of Wednesday’s infrastructure meeting at the White House raised questions about his temperament and behavior, she said.

Mr. Trump had “another temper tantrum,” she told reporters at her weekly news conference at the Capitol. “Again, I pray for the president of the United States. I wish that his family or his administration or his staff would have an intervention for the good of the country.”

The president gave her a derogatory nickname, calling her “Crazy Nancy.”

“She’s a mess. She’s lost it,” the president said during an event to announce $16 billion in aid to farmers, in part to compensate for his tariffs policy on China. That event transformed into a monologue and a question-and-answer session with reporters, which included a revival of an old self-assessment that Mr. Trump is an “extremely stable genius.”

Ms. Pelosi quickly shot back on Twitter, saying, “When the ‘extremely stable genius’ starts acting more presidential, I’ll be happy to work with him on infrastructure, trade and other issues.”

In his own tweets on Friday morning, Mr. Giuliani said he would not apologize for sharing the video.

“Nancy Pelosi wants an apology for a caricature exaggerating her already halting speech pattern,” he wrote, before recalling her comment that Mr. Trump needed an intervention. “First she should withdraw her charge which hurts our entire nation.”

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