Okay, upon reboot, I hear TheUbuntuDrumsOfSouthAfrica(tm) at the login screen, 
but when i get to the desktop, the sound-indicator-icon has three dashes coming 
out of the speaker, and when I open sound-settings I no longer see *any* entries 
under the output tab (I would expect to see spdif + with luck speakersBuitIn), 
nor any entries under the input tab either (I would expect to see internal_mic).  

$ ps aux | grep -i pulseaudio | grep -v grep
(no output -- so my editing of ~/.pulse/client.conf apparently kept it from starting) 

$ alsamixer
(looks fine) 

$ speaker-test -D default -t wav  -c 6 -l 1
speaker-test 1.0.25
Playback device is default
Stream parameters are 48000Hz, S16_LE, 6 channels
WAV file(s)
Rate set to 48000Hz (requested 48000Hz)
Buffer size range from 2048 to 8192
Period size range from 1024 to 1024
Using max buffer size 8192
Periods = 4
was set period_size = 1024
was set buffer_size = 8192
 0 - Front Left
 4 - Center
 1 - Front Right
 3 - Rear Right
 2 - Rear Left
 5 - LFE
Time per period = 8.495962
(works for frontLeft/frontRight only, others silent) 

j@j-P180HMx:~$ espeak "Hi"
ALSA lib pcm.c:2217:(snd_pcm_open_noupdate) Unknown PCM cards.pcm.rear
ALSA lib pcm.c:2217:(snd_pcm_open_noupdate) Unknown PCM cards.pcm.center_lfe
ALSA lib pcm.c:2217:(snd_pcm_open_noupdate) Unknown PCM cards.pcm.side
ALSA lib pulse.c:243:(pulse_connect) PulseAudio: Unable to connect: Connection refused
ALSA lib pulse.c:243:(pulse_connect) PulseAudio: Unable to connect: Connection refused
ALSA lib audio/pcm_bluetooth.c:1614:(audioservice_expect) BT_GET_CAPABILITIES failed : Input/output error(5)
ALSA lib audio/pcm_bluetooth.c:1614:(audioservice_expect) BT_GET_CAPABILITIES failed : Input/output error(5)
ALSA lib audio/pcm_bluetooth.c:1614:(audioservice_expect) BT_GET_CAPABILITIES failed : Input/output error(5)
ALSA lib audio/pcm_bluetooth.c:1614:(audioservice_expect) BT_GET_CAPABILITIES failed : Input/output error(5)
ALSA lib pcm_dmix.c:957:(snd_pcm_dmix_open) The dmix plugin supports only playback stream
Cannot connect to server socket err = No such file or directory
Cannot connect to server socket
jack server is not running or cannot be started
(complains ... but speakers output the word 'hi' anyways) 

$ pulseaudio --start
$ ps aux | grep -i pulseaudio | grep -v grep
j         2749  2.4  0.0 418188  5684 ?        S<l  13:12   0:00 pulseaudio --start
j         2753  0.0  0.0  95956  2980 ?        S    13:12   0:00 /usr/lib/pulseaudio/pulse/gconf-helper
$ speaker-test -D default -t wav  -c 6 -l 1
(fail -- completely silent) 
$ espeak "Hi"
ALSA lib pcm.c:2217:(snd_pcm_open_noupdate) Unknown PCM cards.pcm.rear
ALSA lib pcm.c:2217:(snd_pcm_open_noupdate) Unknown PCM cards.pcm.center_lfe
ALSA lib pcm.c:2217:(snd_pcm_open_noupdate) Unknown PCM cards.pcm.side
ALSA lib audio/pcm_bluetooth.c:1614:(audioservice_expect) BT_GET_CAPABILITIES failed : Input/output error(5)
ALSA lib audio/pcm_bluetooth.c:1614:(audioservice_expect) BT_GET_CAPABILITIES failed : Input/output error(5)
ALSA lib audio/pcm_bluetooth.c:1614:(audioservice_expect) BT_GET_CAPABILITIES failed : Input/output error(5)
ALSA lib audio/pcm_bluetooth.c:1614:(audioservice_expect) BT_GET_CAPABILITIES failed : Input/output error(5)
ALSA lib pcm_dmix.c:957:(snd_pcm_dmix_open) The dmix plugin supports only playback stream
Cannot connect to server socket err = No such file or directory
Cannot connect to server socket
jack server is not running or cannot be started
(fail -- completely silent) 

However, as soon as I ran pulseaudio --start, the speaker-icon in the systray changed from triple-dash to triple-rparens.  
I still only see spdif in the output tab (spkr-built-in definitely gone ... and maybe no surround-profile which ought to be there if I understand david correctly?), but at least I see something.  Input-tab also now show internal-mic again, as expected.  

Since this patch from comment#13 does not seem to be helping, I'm going to revert it for the moment, and try some of the other suggestions.