mm iiiiiiiiiiMwiiiiiinnn ii 8 || ^^^^^^^K OF ..;: ■'., ■ PHE VOICE Ghislani Durant. LIBRARY OF CONGRESS, ©(jail ::■■*.--. UNITED STAT] AMERICA HYGIENE OF THE VOICE. BY THE SAME AUTHOR. RESEARCHES ON THE PHYSIOLOGY NERVOUS GANGLIONIC SYSTEM, AND THEIR APPLICATION TO PATHOLOGY. HORSEBACK RIDING, From a Medical Point of View. SEA-BATHING : ITS USE AND ABUSE. On the Cause, Prevention, and Cure OF TUBERCULOUS PHTHISIS, BEING THE ESSAY TO WHICH THE MEDICAL SOCIETY OF THE STATE OF NEW YORK AWARDED THE " HIRAM CORLISS" PRIZE. ON CONSUMPTION, TO WHICH ESSAY WAS AWARDED THE GOLD MEDAL OF THE ALUMNI ASSOCIATION OF THE MEDICAL DEPARTMENT OF THE UNIVERSITY OF NEW YORK. WILL APPEAR SHORTLY: PRACTICAL OBSERVATIONS ON BRIGHT'S DISEASE. HYGIENE The Yoice ITS PHYSIOLOGY AND ANATOMY. GHISLANI DURANT, M.D., Ph.D., OF THE AMERICAN MEDICAL ASSOCIATION, MEMBER OF THE MEDICAL SOCIETY OF THE COUNTY OF NEW YORK, FELLOW OF THE NEW YORK ACADEMY OF MEDICINE, ETC. % Neto anb ttcmscb (Edition. /^fS OF u. . /o.JAQ.kJsJ, \ NEW YORK: CASSELL, PETTER, GALPIN & COMPANY, 1879. 2 hi Entered according to Act of Congress, in the year 1ST9, by GHISLAXI DTJEANT. In the Office of the Librarian 01 Congress, at Washington, Trout's Printing and Bookbinding Co., 205-213 East \2tli St., NEW YORK. PEEFACE. A new edition of this work having been demanded, I have endeavored to render it still more worthy of the great encouragement hitherto bestowed npon it by the musical world and the public generally. The general plan remains unaltered, but all the chapters have been carefully revised and considerable additions have been made to several of them. As the condition of the voice is in a great measure dependent on the state of the system, and therefore attention to the general health must of necessity exert a beneficial influence upon the voice, I have made the chapter on Hygiene more complete than it was. I trust that the final chapter, containing as it does a description of the diseases most commonly affect- ing those who make use of then- vocal organs, will be found useful. VI PREFACE. As I said in the former edition, this work is not intended as a manual for singing ; it makes no claim whatever to anything beyond what its title imports. In it I have sought to convey such a knowledge of the construction and mechanism of the vocal apparatus as will enable the singer to know what he is making use of, so that he will only ask of each peculiar part that which it can perform, and not task it beyond its power. For this reason, I have entered minutely into a great number of general considera- tions, both theoretical and practical, concerning the vocal organs. A work of this kind is necessarily made up of two orders of elements. The first comprises the results of my own experience as a singer and as a physician ; the second is made up of the communications, experiments and con- clusions of others, verified by personal observation, and may be found at length in the various works, the names of which I have given farther on. GHISLANI DURANT. New York, 1879. CONTENTS. CHAPTER I. PAGE Sound. Pitch, Intensity, Quality, .... 9 CHAPTER II. Theories of the Formation of the Voice, . „ 20 CHAPTER III. Anatomy of the Vocal Apparatus, .... 28 CHAPTER IV. Formation of the Voice, 48 CHAPTER V. Registers of the Voice, 66 CHAPTER VI. Timbre of the Voice, 72 Vlll CONTENTS. PAGE CHAPTER VII. Physiognomy of the Voice, 89 CHAPTER VIII. Respiration, 94 CHAPTER IX. Alimentation, 105 CHAPTER X. Sleep, 119 CHAPTER XL Preservation of the Voice, 125 CHAPTER XII. Diseases of the Voice, 151 APPENDIX, 181 Prescriptions, 185 HYGIENE OF THE VOICE. CHAPTER I. SOUND. PITCH INTENSITY QUALITY. The natural phenomena which are incessantly developing themselves on our earth and in the vast space around us, offer to our view so magnificent a spectacle, that the curiosity of the most listless observer becomes powerfully aroused, and in spite of himself he is compelled, in a greater or less de- gree, to meditate upon the causes capable of pro- ducing such marvellous effects. Ever since scientific men began to attempt the explanation of these natural phenomena, they have observed and collected a great number of facts, quite distinct from each other, which they have classified under such different heads as Light, Heat, Electricity, Sound, etc. We can easily distinguish these phenomena from each other, but when we attempt their explanation, to discover the causes 1* 10 HYGIENE OF THE VOICE. which produce them, we are as much in the dark as we are in regard to the soul, or the vital principle. The human mind, always prone to generalize and to consider unity of means as perfection, went so far as to assign to heat, light, electricity, and sound — and with great probability of correctness — a common principle : vibratory movements or waves acting upon different organs ; and asserted that the different sensations arose from peculiar conditions of relative motion among the elements of which our physical organizations are composed, the conditions of motion being determined by the internal state of the bodies with which we are in contact. May it not be true that the light which strikes the eye produces its impression upon the retina as heat, and that the sounds which strike the ear produce their imj^ression upon the nerves of hearing as motion ? It is the same cause which produces these effects, whether it is propagated through an imponderable fluid as the ether, or through the air, that is to say, by vibration. Indeed, we may go farther still, and say that, since matter manifests itself to us by all these dif- ferent phenomena, which are after all but vibratory movements of the molecules of the body, trans- mitted to us as waves, it results of necessity that vibratory motion is an inherent quality of bodies. For the mind which sees beyond external ap- SOUND. 1 1 pearances, matter, from the very fact that we per- ceive it in some way, is always in motion. If a light is removed from onr eye, so that we see it no longer, shall we say that the vibrations of the ethereal medium have ceased ? If a sound de- scends from a tone excessively high to one so low that we are no longer able to bear it, are we jus- tified in affirming that the sonorous body, or that the air, has ceased to vibrate \ Evidently not. Reason tells us, on the contrary, that the rest is relative only and not absolute, and that the body still vibrates, but that on account of the imperfec- tion of our ear, we are only enabled to perceive those sounds whose vibrations have a certain in- tensity and rapidity, and that vibration may still exist in a sonorous body, although unable to pro- duce an impression on the ear. If, therefore, every thing is in motion, every thing vibrates, every thing resounds, there is only required a medium subtle enough to transmit, and an organ delicate enough to perceive, these vibra- tions in order that we might live in the midst of sounds, as we do in the midst of light. Between light and sound, the analogy has often been made, and this in all ages has given birth to thousands of comparisons between musical tones and colors : between music and painting. That this analogy exists, is indisputable ; but we must 12 HYGIENE OF THE VOICE. be on our guard lest we carry it farther than the nature of the case will allow. It is true that it may serve as a source of metaphor, but we must not claim for it any scientific value whatever. If, since the varying rapidity of vibration produces the different colors as well as tones, in considering the resemblance between music and painting, we should find that the number of vibrations corre- sponding to the red of the chromatic scale bear the same relation to the number corresponding to C of the acoustic scale as that for the orange does to that for D, or that for the yellow does to that for E, or even that the proportion should hold good throughout both the chromatic and acoustic gamuts, nevertheless, we should not be justified in asserting, from this resemblance, that a complete identity had been established ; and imagine that a harpsichord of colors might be constructed on which we would be able to play tunes with the eyes. When we hear a musical scale executed, we need but to listen to a few notes to perceive a difference in the pitch or note of the sounds. This is not the only difference we notice : we know that two sounds alike as to their note may differ as to their volume, or the more or less de- cided impression they make upon the tympanum. We have, therefore, another characteristic differ- ence besides the pitch — the intensity or loudness. SOUND. 13 But is this all? Can we not distinguish the dif- ference between the sound of a fresh, girlish voice, and the rough, worn-out voice of a street-singer ? Or, to use the words of Laugel, " I wish to know why the sighs of the hautboy differ from the twang of the violin, from the blare of the trum- pet, from the subdued sounds of the horn, from the soft nasillements of the bassoon; to under- stand why the varied stops of the organ differ; why its harmonies float froni thunder-peals to sounds so sweet that they seem the flappings of seraphic wings ; why its breath now thrills me through, and now caresses me as with invisible kisses ? " There exists, then, a third character, or distinction of sounds, a character more definite, more decided than the other two, which may be called its physiognomy, its color, its perfume, and which the reader has already recognized as the timbre or quality. We have now all the character- istic differences between sounds ; two notes of the same. pitch, of the same intensity, and of the same timbre are completely identical. PITCH. The pitch, or note of a sound, whether it be acute or grave, depends upon the number of vibra- tions of the sonorous body in a given period of 14 HYGIENE OF THE VOICE. time, as, for example, during a second. The high- est or most acute sound would be the one produced by the greatest number of vibrations of which the ear could take cognizance, and consequently of the most rapid motion of the auditory nerves possible, while, on the other hand, the lowest or gravest note would be produced by the least number of vibra- tions ca]3able of producing an effect upon the ear. But, as we have already said, the sensibility of the nervous apparatus is limited. The number of vibrations must be comprised between given limits, in order that the sound jxroduced shall be audible : should the number of vibrations be too great or too small, the resulting sounds would escape us. It has been found by exjDerinients that the deepest or gravest sound audible to the human ear must be produced by at least from 7 to 15 vibrations per second, and that the sound becomes distinctly audible only when the number becomes some 64. On the other hand, the greatest number of vibra- tions producing the highest or most acute sound audible to our ear, cannot be greater than 30,000, and this number makes a very disagreeable impres- sion upon the ear.* * According to Weber, musicians who possess an extremely accurate and well-trained ear, are able to perceive a difference of pitch when the ratio of the vibrations is 1,000 to 1,001. The difference would be about - 6 ^f of a semitone. SOUND. 15 We will not speak of sounds produced by some 65,000 vibrations in a second, for besides the diffi- culty of obtaining them, they are imperceptible to almost all human ears, though they are distinctly perceptible to certain animals, differently organ- ized from us, cats for example. But this is not all. Besides these sounds which escape the ear on account of the small or of the great number of the vibrations by which they are produced, that is to say, those which are too grave or too acute, we observe also that this same imper- fection of the organ of hearing does not allow it to distinguish between two sounds which differ only by a small number of vibrations — although in reality one may be more acute than the other — so, if a cord is set vibrating, and then, by the ap- plication of a continued and gradually increasing force, the tension of the cord is augmented, the cord vibrates more and more rapidly, and the pitch of the sounds is increased, but by degrees which are inappreciable to the human ear, as may be easily demonstrated by experiment. But between the starting-point, which we will suppose to have been a cord stretched by its own weight, and the extreme point of tension, where the cohesive force of the particles of which the cord is composed, is just sufficient to overcome the efforts of the ten- sile force to produce rupture, many sounds differ- 16 HYGIENE OF THE VOICE. ing in pitch have been produced, and while the ear has not been able to distinguish one from the other, so insensible has the gradation been; just as in the spectrum of the prism the eye is not able to distin- guish the precise point where one color begins and another ends, It has been found necessary, there- fore, to establish a line of decided demarcation be- tween sounds, neglecting those which serve as tran- sitions, and keeping those only which, possessing the most definite qualities, produce, consequently, the most distinct and agreeable impressions. The arbitrary scale, or series of notes produced in this way, is called the gamut. The gamut is, then, nothing but a choice of certain intervals, and the particular name given to each step of the lad- der indicates the moment at which a sound differs sensibly from another. If the sounds of the gamut be made to succeed each other, it will be found that they do not all produce the same sensation of pleasure ; some fully satisfy the ear, by imparting to the sensibility an idea of fulness and completeness ; others excite, disturb, or cause a desire for a more clear, more easy transition, and require, in order that an agreeable impression may be produced, to be com- pleted by one of the former. It is in that happy combination of different intervals, that the charm of melody exists. SOUND. 17 INTENSITY. The intensity of sound results from the amj)li- tude of the vibrations, — in other words, the inten- sity is the quantity of strength with which the body is set in motion ; and, in order that intensity may be appreciated by the ear, it is necessary that the vibrations should be transmitted in their vary- ing amplitude to the tympanum, so that we might define intensity to be the varying degree of motion imparted by the vibrations to the nervous fasciculi. A very weak or grave sound is power- less to stretch the tympanum, or to agitate the nerves of the ear ; while a very violent sound — that caused by the discharge of a cannon, for example — may rupture the tympanum, or produce grave dis- orders in the nervous mechanism of the ear. But between these two extremes there is room for a great variety of agreeable sounds, which music can vary ad infinitum, and by means of which it is enabled to produce its almost unlimited power over its listeners. What is termed expression, if we except a few means borrowed from the timbre, consists almost exclusively of the shades of inten- sity. TIMBRE. (Quality.) Until now, we have examined only the strength and the rapidity of the vibrations, but we have 18 HYGIENE OF THE VOICE. yet to consider their form, and reason tells us that here we shall find the explanation of the timbre or quality. The different molecules of which bodies are composed, are not all disposed in the same way : when a vibratory motion is induced on the body, all the molecules of which it is composed describe orbits around their centre of rest, but their orbits of motion are differently disposed in reference to the direction in which the sound is propagated to reach the ear; some orbits having the plane of motion in the direction of sound propagation, some at various angles ; and these various motions are transmitted to the air and thus to the ear. And still further, in consequence of that varied disposition of the molecules of a body which per- mits some of them to vibrate strongly, some feebly, whilst others remain almost absolutely at rest, it follows that a sound is always, or at least very often, mixed with accessory sounds which disappear in the principal sound. If the string of a violin is forcibly pinched, or set in motion by a bow, a delicate ear will detect at the same time, and like a slight emanation of the fundamental note, the third, the fifth, the octave, etc. Habit enables us to isolate these sounds from one another. They are the elements out of which the science of harmonics is made up. SOUND. 19 A sound, then, taken as a whole, is complex, just as white light is, and just as the prism can separate sunlight into the primary colors, so a nice ear can distinguish, at the same time with the pri- mary, the secondary sounds. Hence we have in the ear" an infinite number of nervous cords, some of which are acted upon violently by the principal vibrations and give the chief impression of tone, whilst others, agitated more feebly by the secon- dary sounds, serve only to modify the principal impression ; and it is for this reason that any per- son, although he may not have a very delicate ear, easily recognizes the timbre. We may, then, define the timbre to be the re- sult of accessory sounds, harmonic when the sound is musical, inharmonic when it is a noise, and say that it varies according to their number and pitch. Experiment has shown that, when the partial sounds change, the timbre also changes, and hence the explanation of the timbre : that as we modify either the molecular arrangement of the substance, or the substance itself which is vibrating, or the column of air which forms the conducting medium, we modify the orbital motion of the molecules, and therefore the accessory sounds ; for the timbre is nothing less than the form of the vibration of the air, reproducing itself exactly on the nervous mat- ter of the ear. (Beauquier.) CHAPTER II. HISTORIC SUMMARY OF THE THEORIES OF THE FOR- MATION OF THE VOICE. Though a great number of theories have been successively advanced to explain the voice, its formation, and the various ]3henomena which it presents, yet they may be all classed under three principal groups : 1st. Those in which the vocal organ is compared to a wind instrument with an inflexible mouthpiece, as the flute, flageolet, or the organ-pipes ; 2d. Those in which it is compared to a wind instrument having a reeded mouthpiece, as the clarionet, bassoon, etc. ; and 3d. Where it is supposed to resemble a string instrument, or one partaking both of the character of a string and wind instrument. A brief summary of the opinions held by some of the most eminent physiologists, of both ancient and modern times, will show this statement to be correct. Hippocrates, 400 B.C., says : " Man speaks by the air which he draws in the whole body but especially in the cavities. Pushed to the exterior HISTOETC SUMMAEY. 21 by the vacuum, the air engenders a sound, the tongue articulates by its clashings, intercepting it in the throat, and striking against the palate and the teeth, it makes the sound distinct." Ninety years later, Aristotle defines the voice to be "a certain sound produced by a living body, for inanimate things have no voice." He compares the organs of the voice to a flute ; the trachea being the body of the instrument. Plato, 429 b. c, defines the voice to be " a rust- ling in the air reaching the soul through the ears." Galen, 131 b. c, shows a far more intimate ac- quaintance with the structure of the vocal appa- ratus, for he states the thorax to be the bellows, or reservoir for air ; the vocal cords, the sonorous vibrating body, by which the sound is produced, and the palate and mouth to correspond to the tube of a wind instrument, by which the sounds are modified, — the whole apparatus being consid- ered by him as analogous to a flute. In the 16th century, Jerome Fabricio, speaking of the vocal apparatus, says : " The general efficient cause of sound is a body capable of condensing, compressing, striking the air, and making it break forth." His description would make the vocal organ similar to an organ-pipe. Mersenne, 1588, says: "The faculty or motive power of the soul is the principal and first cause 22 HYGIENE OF THE VOICE. of the voice in animals and has its seat in the ten- dons." However, Mersenne did not say whether he considered the vocal instrument as wind or string. Claude Perranlt, 17th century, says : u The voice is a sound of verberation, which the air enclosed in the chest excites in sallying forth violently, and in grazing the membranes constituting the glottis, so that it shakes its parts, and disseminates its parti- cles, the return of which causes an agitation in the air, capable of making an impression on the organ of hearing." He also classes the vocal organ with instruments of the flute kind. Dodart, 1700, says: "The voice is a sound — sound is an effect of the air beaten violently — the matter of the voice is the air contained in the lungs, pushed from downward upward, from inside outside. The resounding of any sound, and con- sequently that of the voice, supposes the voice already formed, and is only the continuation of the sound. The glottis alone," said he, "forms the voice and all its tones." He compares the organ of the voice to a horn or trumpet. Ferrein, in 1742, was the first who attempted to draw sounds from the larynx of the dead. " I ap- proximated," said he, " the lips of the glottis, and blew with force into the windpipe; upon this the organ seemed to take life, and sent forth, I will HISTORIC SUMMARY. 23 not say a sound, but a loud voice, more agreeable to me than the most touching music." Ferrein considered the larynx as a stringed instrument, and compared it to a violin. The great naturalist, Cuvier, compared the vocal organ to a flute, and looked upon the glottis as the mouthpiece of the instrument, the mouth as the body or tube, and the nares as the lateral open- ings. Dutrochet, 1806, held " that the production of the voice was an active phenomenon, depending upon the vibration of the fibres forming the thyro- arytenoidean muscles; and that the vocal tube is supposed to have no influence whatever on the production of tones." Despiney de Bourg, 1822, stated "that the sounds formed in the glottis undergo at that aper- ture great variations; to reach the outside they escape through the pharynx, a muscular canal sus- ceptible of experiencing numerous changes, and able, besides, to modify these sounds ; that canal may be compared by its influence to the gliding coulisse of a trombone." Felix Savart, 1825, says, that "it is easy to com- prehend the formation of the voice if we consider the vocal organ, composed of the larynx, the pharynx, and the mouth, like a conical tube in wh?ch the air is brought by a movement analo- 24 HYGIENE OF THE VOICE. gous to that taking place in the flute-stop of an organ. Malgaigne, 1831: "The voice is a particular sound produced ordinarily by the passage of the expired air in the aerial tubes." His experiments led him to consider the voice as a reed instrument. Richeraud, 1833, declared the voice to be "an appreciable sound resulting from the vibrations which the air, sent forth by the lungs, experiences in passing through the glottis." Richeraucl holds a juste milieu among the opinions already given, for he considers the vocal organ at the same time both as a string and a wind instrument. Bennati, 1833, believes "that it is not the mus- cles only of the larynx that serve to modulate the sounds in singing, but also those of the os hyoicles, those of the tongue, and those of the superior, an- terior, and posterior parts of the vocal pipe, and that without the simultaneous and proportionally combined work of these, the degree of modulation cannot take place." Dr. James Rush, 1833, says: "All we know is, that the voice is caused by the passage of air through the larynx and cavities of the mouth and nose." Magendie, 1836 : "We understand by voice the sounds produced in the larnyx at the time the air passes through that organ, be it to enter the wind- HISTORIC SUMMARY. 25 pipe or to leave it." He makes the vocal organ a reed instrument. Colunibat, 1838, states : " The voice is an ani- mal sound, living and articulate ; of which the air is the material cause, and the glottis the efficient cause." Dr. John W. Draper, 1850, says, that "articu- lation is effected by the motions of the tongue and other portions of the mouth ; sound is produced by the glottis, speech by the mouth." Miiller, 1851, states, that "in the formation of the voice, the windpipe acts as a wooden pipe of like diameter would do." Manuel Garcia: "The voice is formed by the periodical compressions and dilations which the air experiences wheu, on reaching the glottis, the latter, by alternate and regular movements, stops or permits its exit." Dr. John C. Dalton, Jr., 1859: "That when a vocal sound is to be produced, the vocal cords are suddenly made tense, and applied closely to each other so as to diminish very considerably the size of the orifice : and the air driven by an unusually forcible expiration through the narrow opening of the glottis, in passing between the vibrating vocal cords, is itself thrown into vibrations, which pro- duce the sound required." A. Debay, 1861 : " The voice may be defined as 26 HYGIENE OF THE VOICE. the sonorous vibrations which are produced by the air, expelled by the lungs through the glottis, and escaping through the pharyngo-buccal cavity." Dr. Ed. Fournie, 1866 : "The voice is a sound produced by a particular reed having walls modi- fiable under the influence of muscular action ; the vibrating part being furnished by the mucous fold which limits the borders of the glottis. The vi- brations are occasioned by the passage of the air through the glottis." Dr. James Yearsley, 1866: a The term applies properly to the sounds produced by the action of the air on the vocal cords in the larynx." L. Mandl, 1872: u The air in passing through the glottis is thrown into vibration and a sound called the glottic sound is produced ; this, com- bined with the sounds produced by the air passing through the pharyngeal cavities, — the pharyngeal sounds, — constitutes what is generally known as the voice." My ideas regarding the formation of the voice do not differ materially from those given above. The vocal ligaments in a state of rest, are not brought into close juxtaposition, but for the ut- terance of sound, they are approximated by mus- cular' action, dependent upon volition, and the vocal ligaments act in the same manner as two membranous lips, which, as the air is forced up HISTORIC SUMMARY. 27 by the expiratory effort, are thrown into vibra- tion, and thus produce the voice. This phenome- non requires the concourse of a great number of organs ; the walls of the thorax, the lungs, the larynx and trachea, the mouth and nasal fossae. However, the larynx alone essentially belongs to the voice. Let us now pass from the summary of the vari- ous opinions held, concerning the mode of pro- duction of the vocal sounds, to the consideration of the anatomy of the individual parts, in order that we may understand clearly and appreciate fully the wonderful delicacy, simplicity, and beau- ty of the mechanism, which is one, if not the prin- cipal, means of communication between man and man, and which therefore affects not only his physical, but also his mental condition. CHAPTER III. ANATOMY OF THE VOCAL APPARATUS. The organs concerned in the production of vo- cal sounds are composed of three separate and dis- tinct portions, 1st. The lungs (analogous to the bellows of an organ), and trachea, which furnish and convey the air necessary to produce the vibrations. 2d. The larynx, containing in its interior the vocal cords. 3d. The pharynx, mouth, and nasal anfractuosi- ties, which serve to modify the sounds produced in the larynx. I. THE LUNGS AND TRACHEA. The lungs, the organs of respiration proper, are tivo in number, situated side by side in the thora- cic cavity, surrounding the heart and occupying almost all the chest, except a very small space to the left of the median line where the heart may be felt to beat against the wall of the chest. They are separated from the abdominal cavity by the ANATOMY OF THE VOCAL APPARATUS. 29 i fM W A The Tongue. B The Cavity of the Month. C The Uvula and Soft Palate. D The Nasal Fossae. E The Passage communicating with the Nose. F The Pharyngeal Cavity. G The Epiglottis. IT The Rima Glottis, or Opening of the Lai-ynx. / The Vocal Ligaments, or Corde Vocali. K The Larynx. L The Trachea, or Windpipe. M The Bronchial Tubes. N The (Esophagus. P The Spinal Vertebrae. 30 HYGIENE OF THE VOICE. Fig. 2. HUMAN AIR-TUBES. The mode of distribution of the air-tubes is represented in Fig. 2 (Draper's) : a is the larynx ; b b, the trachea, the upper letter corresponding to the cricoid cartilage ; c, the left bronchus ; d, the right bronchus ; e, /, g, its ramifications in the right lung, j j ; h, i, ramifications of the left bronchus in the left lung, k K DISTBIBUTION OF CAPILLARIES ON AIR-CELLS OF THE LUNGS. ANATOMY OF THE VOCAL APPARATUS. 31 diaphragm, a sort of muscular membranous parti- tion ; their size varies with the capacity and con- dition of the chest, the age and sex of the individ- ual, the state of the health, and their condition at the time, whether of expiration or inspiration. They are conical in shape, the apex of the cone being directed upward ; the right lung being shorter, but larger than the left, whose transverse diameter is somewhat shortened by the position of the heart. Their color is a light pinkish tint speckled with black. The lungs are spongy in structure, and consist of air-vessels, air-cells or vesicles, nerves and blood- vessels, held together by the ordinary packing material of the body, cellular tissue, and are cov- ered by the pleura, a shining membrane which is kept constantly lubricated so that they may move without friction or injury ; the spongy character of the lungs is due to the air-vesicles. If we examine the respiratory organs of any animal, the lights as they are commonly called, we find that the trachea divides into the bronchi, and these again divide and subdivide, diminishing in size till they become mere capillaries, losing their cylindrical shapes from the great number of air-vesicles (about y^- of an inch in diameter), which open upon their sides, and finally terminate in one of these vesicles. A certain number of 32 HYGIENE OF THE VOICE. vesicles communicate directly with each other, and with a single branch of the bronchial tube, and are separated from neighboring air-cells by parti- tions of cellular tissue — parenchyma— and thus are formed the lobules of the lungs. We may, there- fore, consider the lung as nothing more nor less than a collection of these lobules packed in cellular tissue, held together by the ramifications of the bronchi, which open in the midst of them, and thus put them into communication with the external air, through the air-passages consisting of the trachea or windpipe, the bronchi, and their divi- sion. If by careful dissection a lung be freed from nervous, vascular, and cellular tissue, the bronchi and their ramifications, which will then alone re- main, will be found to bear a very close resem- blance to a tree with its branches. Cruveilhier remarks that the size of the lungs, corresponding exactly with the capacity of the thorax, is therefore, like it, subject to variations ; and as, on the one hand, the size of the lung is generally a measure of the energy of respiration, and, on the other, the energy of the respiration is a measure of the muscular strength, it follows, that a capacious chest, coinciding with broad shoulders, is the characteristic of a sanguine tem- perament and athletic constitution. ANATOMY OF THE VOCAL APPARATUS. 33 The trachea or 'windpipe, which carries the air to and from the lungs, is a cylindrical tube four or five inches in length, situated in front of the oesophagus or gullet — which carries food to the stomach, — extending from the larynx above to the third dorsal vertebra below, where it divides into two tubes, called the right and the left bronchus, which go to the corresponding lung ; then the bronchi continue to subdivide until they become capillaries. The windpipe is formed of from six- teen to twenty cartilaginous rings, connected by ligamentous tissue of an elastic character ; these rings are about two lines in breadth, and form the anterior two-thirds of the tube, but are deficient in the posterior third, which is completed by a muscular structure, whose fibres are placed trans- versely and which possess much elasticity, to allow for the distention of the oesophagus while the food is on its way to the stomach. The object of the rings is to prevent the falling in of the walls of the trachea during inspiration, and so to allow of the free access of air. The first ring is the largest, and the last is of such a shape as to be adapted to the first rings of the bronchi. The bronchi are essentially of the same struc- ture as the trachea, except that the rings are com- plete; the right bronchus is shorter, but of a larger diameter than the left ; these soon ramify o4 HYGIENE OF THE VOICE. into numerous subdivisions which finally termi- nate in the lobules of the lungs. II. THE LARYNX. The larynx, the upper portion of the air-pas- sages, is situated at the upper and anterior part of the neck, between the base of the tongue and the trachea, with which it is continuous below, and in front of the membranous canal which con- ducts the food to the stomach. The larynx is narrow and cylindrical below, but larger above, where it presents the form of a tri- angular box ; it is formed of cartilages connected by ligaments moved by numerous muscles, lined by mucous membrane and supplied with nerves and blood-vessels. The cartilages forming the larynx are nine in number, viz. : the th} r roid, the epiglottis, the cricoid, 2 cornicula laryngis, 2 arytenoides, 2 cuneiform. The thyroid (from Gr. &vptog tiSog, like a shield), is the largest of these cartilages and the one form- ing the greater portion of the larynx. It consists of two quadrilateral plates or lamellae, united in the median line in front at an angle of about 70°, ANATOMY OF THE VOCAL APPARATUS. 35 True vocal cord. Arytenoid cartilage. ., Thyroid cartilage. - Elastic ligament. BHAPE OF THE GLOTTIS V7HEN AT REST. — [h. HOLDEN.] Arytenoid cartilage.. Crico-arytenoid joint- Crico-thyroid joint. Thyroid cartilage. Thyroid cartilage depressed. True vocal cord. True vocal cord stretched. Crico-thyroid muscle. Cricoid cartilage. DIAGRAM SHOWING THE ACTION OF THE CRICO-THYROID MUSCLES. ANATOMY OF THE VOCAL APPAKATUS. 37 forming the pomtmi Ad ami, or Adam's apple. It forms the upper and anterior portion of the larynx, but is opened behind. The cricoid (Gr. xgixog siSog, like a ring), shaped like a seal ring, is placed horizontally be- low the thyroid, and above the trachea, and has its narrow portion in front, the wider behind, and fills up the posterior opening of the thyroid ; it forms the base of the larynx. Its superior or upper border unites by means of a membrane with the inferior border of the thyroid and arytenoid cartilages ; infe- riorly it corresponds with the first ring of the trachea or windpipe, of which it seems a continuation. The arytenoides (Gr. aovrcuva u§og y ladle- shaped), are two small prismatic or pyramidal- shaped cartilages, standing in the open space of the thyroid, and upon the posterior portion of the cricoid, and united by their anterior borders to the posterior border of the preceding, and are there- fore in the upper and back portion of the larynx. Their base is broad and concave, and articulates or unites with the cricoid, and is terminated by two apophyses, the posterior or external, and the anterior or internal ; to the former are attached the lateral and posterior crico-arytenoid muscles, while to the latter, and the depression between the two alse of the thyroid cartilage, are attached the inferior or true vocal cords. 38 HYGIENE OF THE VOICE. The comicula laryngis and the cuneiform car- tilages do not need describing in order to under- stand the mechanism of the voice. The former are cartilaginous nodules situated at the apices of the arytenoides ; the latter small elongated bodies situated at the side of the arytenoides. Finally we have the epiglottis, a thin leaf -shaped fibrocartilaginous plate, situated behind the root of the tongue, at the superior portion of the larynx ; its name might lead us to believe that it is situated immediately over the glottis ; but it is placed much higher up. Its ordinary position is perpendicular, leaving the glottis free for respira- tion; but during the elevation of the larynx in deglutition it becomes horizontal, falls over the glottis, and prevents the entrance of food into the larynx. In the production of acute sounds, the epiglottis concurs in the expulsion of the air by the nasal fossae, and thus participates in the vibratory motion of the air, and although foreign to the modifica- tions of the voice, may contribute to its timbre. Suspended as the larynx is to the hyoid bone (a horseshoe-shaped bone situated at the base of the tongue, with its rounded portion in front), it ascends and descends with it, and in order that it shall concur in both phonation and deglutition, it must execute certain movements as a unit, and to 40 HYGIENE OE THE VOICE. Fig. 6. Vocal cord, Thyroid cartilage. Cricoid cartilage. . Arytenoid cartilage ... Elastic ligament (g (crico - arytenoid) ■ Thyro-arytenoi- deus. sy^x Crico - arytenoi- ; 'fe'-C,\ deus lateralis. Crico - arytenoi- deus posticus. GLOTTIS DELATED. MUSCLES DILATING IT KEPEESENTED WAVY. Arytenoid carti- lage Elastic ligami Thyro-arytenoideus . |j^r- Crico- arytenoideus '^V\ lateralis. _ Crico - arytenoideus posticus. GLOTTIS CLOSED. MUSCLES CLOSING IT BEPEESENTED WAVY. ANATOMY OF THE VOCAL APPAEATUS. 41 enable it to do this, the several parts of which it is composed are united by means of fibrous and membranous ligaments. Thus between the thyroid and cricoid we have the crico-thyroid ligament ; between the thyroid and arytenoid, the thyroary- tenoid ligaments. Thus far we have examined the formation, posi- tion, and exterior portion of the larynx ; now let us examine its interior arrangement and strive to learn its functions and their modus operandi. First, we have the superior orifice, an oval space bounded in front by the epiglottis, behind by the arytenoid cartilages, and on the sides by folds of the mucous membrane. Below this and toward the middle of the larynx, we observe an oblong triangular slit between two membranous folds, which are stretched horizontally between the re- ceding angle of the thyroid and the two internal apophyses of the arytenoides; these are the in- ferior or true vocal cords ; so called to distin- guish them from two other folds of membrane placed parallel to and above them, which are called the superior or false vocal cords, since they do not, as far as has been ascertained, contri- bute in any way to the formation of sounds ; on either side, between the true and false vocal cords, are two oblong fossae called ventricles. The glottis, often confounded with the upper 42 HYGIENE OF THE VOICE. opening of the larynx, is the interval or space be- tween the vocal cords, and is, therefore, situated about the middle of that organ. It is elliptical' or linear in shape, according to the moment at which it is observed. Its length and width vary in different individuals as the corresponding di- mensions of the larynx do. They are greater in man than in woman. There is a regular movement of opening and clo- sing of the glottis, which seems to be determined by the respiration. It remains open during the time the air is entering the lungs, but closes par- tially during a part of the time that the air is leaving them. Dilatation, however, begins before the close of expiration, and proceeding with it, leaves the aperture open to its fullest extent, at the moment when the following inspiration is to begin. The two inferior or true vocal cords consist es- sentially of the thyro-arytenoid muscles covered by strong fibrous bands (inferior thyro-arytenoid ligaments) which in turn are covered exteriorly by a thin membrane ; they are about two lines in width, and from eight lines to an inch in length ; they are attached in front to the depression be- tween the two alse, or wings of the thyroid; be- hind, to the anterior angles of the arytenoides ; and at the sides, to the thyroid, by the lateral at- ANATOMY OF THE VOCAL APPARATUS. 43 tachment of the muscles. These ligaments with their covering are so attached, both in front, be- hind, and on the sides, that we may well assert they are incapable of vibrating so as to produce vocal sounds ; but this exterior envelope (the vo- .cal membrane of Dr. Ed. Fournie), is a very fine, transparent, and highly elastic membrane, so ar- ranged on the interior border of the vocal cords that the slightest breath is sufficient to set it in motion. This membrane surrounds the vocal cords as a well-fitting glove does the hand, and may be readily detached from the interior border of the cords, but adheres more closely to their body. The movements of the cartilages of the larynx are performed by means of nine muscles, of which eight are in pairs, viz., the crico-thyroidei, the cri- co-arytenoidei postici, the crico-arytenoidei latera- les, and the thyro-ary tenoidei ; and one single, the arytenoideus. The crico-thyroid muscles are inserted partly into the anterior face of the cricoid, partly into the in- ferior border of the thyroid; they approximate the anterior portion of these two cartilages more closely. By this motion, the thyroid is made to re- cede from the arytenoid cartilages, and thus the vocal cords are stretched between them. The posterior crico-arytenoid muscles extend 44 HYGIENE OF THE VOICE. from the lateral portions of the cricoid to the pos- terior apophyses of the base of the arytenoid car- tilages. These muscles, when contracted, tend to carry the arytenoid cartilages, and the vocal cords attached to them, outward toward the cricoid, and consequently dilate the glottis. The lateral crico-arytenoid muscles extend from the lateral portions of the superior borders of the cricoid to the posterior apophyses of the arytenoid ; by their action they draw together the internal apophyses of the arytenoid cartilages, and there- fore approximate the true vocal cords, and so nar- row the glottis. The thyro-arytenoidei arise from the inferior third of the receding angle of the thyroid, and are in- serted into the internal apophyses of the aryte- noid ; their greater fasciculi are lodged in the tex- ture of the vocal cord itself ; they elevate the front of the thyroid, draw it toward the arytenoid, and thus relax the vocal ligaments. The arytenoid muscle extends from one to the other arytenoid cartilage, being attached to the posterior and external portions ; its action is to approximate these cartilages, and consequently to constrict the glottis. Finally, the larynx is supplied with a number of small glands, concerning the function of which but little is known; their use seems to be to ANATOMY OF THE VOCAL APPARATUS. 45 secrete a mucus, which lubricates the larynx and epiglottis, keeps them moist and soft, so that mo- tion shall be attended with as little friction as possible, and prevents irritation by the constant passage of air to and from the lungs during in- spiration, expiration, singing, or speech ; they are, the epiglottics, the subglottic^, the arytenoid, and the ventricular. There are none on the vocal cords. The arteries are derived from the laryn- geal branch of the superior and inferior thyroid. The veins empty into the thyroid veins. The nerves are the superior and inferior or recurrent laryngeal ; the superior or sensor supplies the mucous membrane and crico-thyroicl muscles ; the inferior laryngeal, the remaining muscles. The arytenoid is supplied by both. HI. THE PHARYNX. If you inspect some friend's throat, or your own, by means of a mirror, you perceive the open- ing into the throat — the isthmus of the fauces — the posterior wall of which is formed by a con- tractile surface, lined with mucous membrane. This is \he pharynx — the buccal face of the velum palati, or soft palate, which forms an incomplete partition between the mouth and the pharynx — in the median line a small, pendulous, conical 46 HYGIENE OF THE VOICE. body, the uvula or hanging palate — extending from the base of the latter, right and left, two folds of membrane forming an arch ; these are called the pillars of the soft palate ; they bound on either side a small cavity, in which is lodged the amy g dale glands or tonsils. The other parts which make up the organs of sound are the mouth and nasal fossaB. The nasal fossw are two irregular-shaped cavi- ties separated by a thin partition, situated in the middle of the face, and extending backward. They open by their anterior orifice upon the face, while their posterior opening is on the pharynx ; they communicate with four sinuses, or cavities in bones, the frontal, sphenoidal, ethmoidal, and max- illary — the particular use of which will be ex- plained hereafter; they serve to increase the di- mensions of the vocal pipe. The cheeks, during phonation, are almost pas- sive, yet, being under the control of the muscles of the mouth, they may dilate or contract the buccal cavity, and so increase or diminish the size of the vocal organ. The mouth plays a very important part in the modification of sounds, since it is formed of parts extremely mobile, and therefore well suited, by the disposition and movements of its parts, for forming the particular cavity best suited for the ANATOMY OF THE VOCAL APPARATUS. 47 special sounds ; besides which it imparts a partic- ular sonorousness to the voice. The lips , by being projected forward or drawn backward, lengthen or shorten the anterior-poste- rior diameter of the buccal cavity, and so increase or diminish the length of the vocal pipe, and by their contraction regulate the size of its opening. Finally, to terminate these dry details of anat- omy, already too long, we have to mention the tongue, which of all parts of the mouth is most essential in modifying the vocal sounds, since it forms by its various positions the vowels and con- sonants, or increases or diminishes the buccal cavity. CHAPTER IV. FOEMATIOJS" OF THE VOICE. To understand the operation of the vocal appa- ratus in order to produce sounds, it is necessary to advert to the condition under which notes are pro- duced by instruments having some analogy to the larynx : — these, as we have already seen, may be divided into three kinds, strings, nutepipe, and reeds. Ferrein, long ago, compared the vocal ligaments to vibrating strings, and, at first sight, there seems to be a considerable resemblance between them, the pitch of the note in both being high or low, according as tbe tension of the cord is increased or diminished. But on accurate observation this re- semblance disappears, for we may easily satisfy ourselves by experiment that no string as short as the vocal cords could give a clear note as low as the middle notes even of the human voice ; again, the changes produced by tension are very differ- ent. In a vibrating string, the number of vibra- tions are to each other as the square root of the extending weight. Thus, if a string be stretched FOEMATIOIST OF THE VOICE. 49 by a weight of 1 lb., and again by a weight of 9 lbs., the number of vibrations will be as 1 to 3, or the last note will be the 12th above the 1st. Muller has shown that this condition does not [hold in the larynx, that the sounds produced by a variation of the extending force do not follow the same ratio ; finally, although a string adapted to perform the lowest note of the human voice may, by increased tension, be made to produce all the higher ones, yet it does not follow that one which, with moderate tension, as in the vocal ligaments, produces a high note, can be made to produce all the lower notes by diminished tension, for the vibration becomes irregular from diminished elas- ticity. We see this in the case of the violin and violoncello, the long strings of the latter being necessary for the production of a good bass note. The next class of instruments with which it might be compared is the flute. Here the pitch of sounds is determined almost entirely by the length of the vibrating column of air, though the sound is modified slightly by the diameter of the column and the kind of embouchure or mouth- piece. Here we find the pitch to be in inverse proportion to the length of the pipe, so that of two pipes, one being twice as long as the other, the shorter pipe would give a note an octave higher than the other, the vibrations being twice 3 50 HYGIENE OF THE VOICE. as rapid. The length required to produce the lowest G- of the ordinary Bass voice is nearly 6 feet — so that there is nothing in the form or di- mensions of the larynx and mouth which render it capable of producing the vibrations required for the tones of the voice. We have now to consider the third class of in- struments, those having a reed or tongue. These reeds may be elastic in themselves, or be made elastic by tension. We have two kinds of reed instruments, those having a " free " reed, as the accordeon, harmonium, etc., and those having a reed and pipe, as the bassoon, hautboy, etc. In the former, the pitch of the note is dependent en- tirely on the elasticity of the reed ; in the latter, upon the elasticity of the reed and the length of the tube. The researches of Weber are of great import- ance in determining the true nature of the vocal apparatus. He found : 1st. that the pitch of a reed could be lowered, but could not be raised by joining it to a pipe. 2d. The sinking of the note is not more than an octave. 3d. The fundamen- tal note of a reed could be lowered by lengthen- ing the pipe, but again restored by a further lengthening, and again lowered by a further in- crease. 4th. The length of tube necessary to change the pitch of the note depends upon the re- FOEMATIOIST OF THE VOICE. 51 lation between the number of vibrations of the reed and the number of vibrations of the column of air in the tube. . . . From these considerations and the preceding paragraph, we see that if the tube may be made to yield tones of any depth by prolonging it, the embouchure being the same, it must be considered as a flute ; but if it can be lowered only an octave or less, with the same embouchure, it must be classed as a reed ; — the latter is the case with the larynx. We now see what is the true character of the vocal apparatus, that the sound is the result of the vibrations of the vocal ligaments, and that these vibrate in the same manner as the reed of any musical instrument, and that the pitch, though determined chiefly by the amount of tension of the vocal cords, which decreases or increases the size of the glottis, is also the result of the ascent or descent of the larynx, which shortens or lengthens the vocal pipe. As yet we know little concerning the mode in which tones are modified by the air- passages, both above and below the larynx, but that they are so modified there can be no doubt, if we observe the great amount of muscular con- traction taking place dining singing or speech. The production of a note presupposes two indis- pensable conditions : 1st, a body capable of vibra- 02 HYGIENE OF THE VOICE. ting ; 2d, an agent, competent to produce these vibrations. The first condition we have seen fulfilled in the larynx, which contains the chordae vocales. The second, in accordance with that beautiful provi- sion of nature that nothing shall be useless, we find in the air introduced in the lungs, and which, hav- ing undergone change, has therefore become a waste product. The mode of producing sound in the larynx is as follows : as long as the vocal cords retain their usual relaxed condition during expiration, no sound is heard, except a faint whisper as the air gently passes the cavity of the larynx ; but when a sound is to be produced, the vocal cords are suddenly made tense and drawn parallel (for when they diverge ever so little, no sound is produced), and applied in close proximity to each other, whereby the size of the orifice is greatly dimin- ished ; then the air, driven by an unusually forci- ble expiration past the vocal ligaments, sets them in vibration, and in this manner vocal sounds are produced. The tone, pitch, and intensity of this sound vary with the conformation of the larynx, the degree of tension and the approximation of the vocal cords, and the force of the expiratory effort. The narrower the opening, and the greater degree of tension of the cords under ordinary cir- FORMATION OF THE VOICE. 53 cumstances, the more acute the sound produced, while a less degree of tension and wider opening produce a grave note. To have some conception of the variety and delicacy of the motions neces- sary to the adjustment of the vocal C, listen to some singer whose voice commands with ease a great extent of the scale. For every note there is a particular adjustment of the vocal cords. It is calculated that in man the ligaments vary in length about j*- of an inch, and in woman J. Now, the natural compass of most singers is about two octaves, or 24 semitones. Between each semitone an ordinary singer can sound 5 or 6 distinct notes, so that 120 would be only a moderate number of distinct sounds. He, therefore, produces 120 dif- ferent states of tension, and as the extreme vari- ation is only ^ of an inch, the variation required to pass from one note to another is but the -g-J-g- of an inch. A very expert singer can produce a much more delicate action than this. The celebrated Madame Mara, whose voice ranged through three octaves, could, it is said, produce between each tone-sound 100 different intervals, or 2,100 in all, so that she could determine the contractions of her vocal liga- ments to nearly 1 7 ^ 00 of an inch. The quality of the voice is also modified by the length of the column of air included between the 54 HYGIENE OF THE VOICE. glottis and mouth, and that in the trachea, the tense or relaxed condition of the walls of the pharynx and fauces, and that of the nasal anfrac- tuosities and the state of dryness or moisture of the mucous membrane lining aerial passages. Articulation, or that modification or division of vocal sounds producing vowels and consonants, is accomplished by means of the tongue, teeth, lips, nasal passages, and fauces. THE MALE AND FEMALE VOICES. When we compare the male and female voices, we notice at once a great difference between them, yet the mechanism concerned in the production of the female voice is absolutely the same as that in the male. We find iifboth the larynx, lungs, and air-passages constructed in the same manner, and the same registers, chest, mixed, and falsetto. It is in the more or less frequent use of one or the other of these registers that one of the principal distinguishing differences between the male and female voice exists ; for whilst man produces his most beautiful effects with the chest register, woman possesses but few notes in that, but sings specially in the mixed register. The pitch of the vocal instrument of the male differs essentially from that of the female. FORMATION" OF THE VOICE. 55 Though vocal music is written in the same way for both, though there are the same notes, the same staves, yet the same note executed by a man will not have the same value when executed by a woman, and when both sing the same piece, the woman always sings an octave higher than the man. This would lead us to suppose that the vocal instrument of woman was but one half the size of that of man ; but this is not the case, that of woman being one third only smaller ; consequently we must seek some other cause to expjain this dif- ference. This is found in the nature of the tissues composing the vocal parts, their thickness and rigidity having a great influence upon the note produced. In woman we find them thinner, more elastic than in man, especially the vocal membrane which leads to the production of sounds of a more acute pitch. Though the voice of woman is less harmonic than that of man, yet it possesses a peculiar sweet- ness, and soft sonorousness which that of man does not. This has been well described by Gerdy * " Woman's voice is less strong than that of man ; it is a charm which nature has given her to move us, to soften, to seduce us, to conquer and subju- gate us ; it seems as if the fibres of our heart were always in its unison." Woman's voice is less strong, less intense than 56 HYGIENE OF THE VOICE. that of man. This seems due to the smaller size of her vocal apparatus. The thoracic cavity of woman is less spacious and the muscles which move it less strong, hence there is a less quantity of air set in motion; on the other hand, her voice is softer and sweeter. As to the range of the voice it is almost the same in both sexes. DEVELOPMENT OF THE VOICE. Scarcely has the child entered the world before it utters a disagreeable cry, to which the name of wailing has been given. Indeed, as the babe only makes itself heard to express a want, a suffering, the wailing of the child is the cry of pain, it is painful to listen to and excites painful sentiments. Its squalling, disagreeable character may be ac- counted for by the fact that the vocal pipe pos- sesses none of the elements necessary to modify advantageously the sounds produced by the lar- ynx. The mouth presents too small a cavity to produce a harmonic resonance of the voice ; the other parts are also but imperfectly developed, and it has not as yet learned the use of the mus- cles which modify the parts. Voice is the principal means of communication between the parent and child, and its development FORMATION OF THE VOICE. 57 is always in proportion to the necessities of the latter. In the first periods of life the child is only related to society by the material assistance de- rived from it. To sustain life and to develop its body are its only wants, and for their expression the monosyllabic cry suffices. As the child grows, sounds little by little lose their disagreeable character, but they do not ac- quire the soft sonorousness of the developed voice, until the little being by a few words shows the first operations of its mind. The eagerness to repeat the sounds heard, to call persistently for objects or persons liked, very soon produces a modification in the monotony of the voice. From this period until they are 6 or 7 years old development of the vocal organ is much more connected with intellectual than with organic life. Speech now becomes the means of develop- ing and perfecting the voice. The development of the voice requires the most assiduous attention, and it is in youth that the vocal education must begin. We must strive, by every possible means, to obtain all the modifica- tions of which an instrument, so admirable and so precious as the voice, is capable. Too great atten- tion cannot be paid to the cultivation of the articu- late voice. Children should be made to read aloud, pronouncing rigorously all the syllables, and so 3* 58 HYGIENE OF THE VOICE. managing their voice as to give the exact meaning of the phrase. They should avoid breathing too often or too abruptly, which might occasion a kind of hiccup, determining an irritation of the mucous membrane of the vocal cords, and so produce a hoarseness difficult to overcome. Having educated the hearing of children so that they will enjoy music, and taught them to open their mouth, and to give it the form most favora- ble to the production of the particular sound de- sired, the next step will be to make them execute very slowly, not entire scales as is ordinarily done, but only the notes which they are able to produce without effort. This exercise should be repeated daily, but should not be continued longer than a quarter, or at the most, a half hour, according to the constitution of the child, lest the powers of the wind chest should be too strongly taxed. If this plan is followed, the muscles will learn to contract spontaneously under the influence of the will, and gain strength, and power of executing different notes readily and with ease. This strength and power of execution is precisely what is wanting in people who have learned to sing late in life, since muscles left until they have attained their full development in inaction, oppose greater resistance to the will than those which in youth have been trained to obey it. FORMATION OF THE VOICE. 59 It is also of the greatest importance that young people should not be allowed to sing pieces not completely within the range of their voice, nor to strive to reach certain notes by too great nor too prolonged efforts, lest they should lose whatever disposition they may have for singing. If the attempt to execute certain musical compositions can alter, or even destroy, voices already formed, would it not, if it did no worse, prevent the de- velopment of vocal organs, yet young and delicate ? Until the age of 13 or 14, the voice of the young girl differs but little from that of the boy; but from this time they begin to change. The boy's voice is to become that of a man ; the girl's that of a woman. The time at which this change be- gins is the age of puberty. Until puberty, the youth has lived for himself alone. To develop his organism has been almost his sole care ; but having arrived at that period, eloquent signs indicate that a great change is about to take place in his organism. A new function is to be established, and henceforth man can produce a being similar to himself. The modification of the voice, which always occurs at that time, is one of the chief symptoms of the setting in of the gen- erative function ; and it is to this modification that the term vox rauca, change of voice, or break, " la mue " of the French, has been applied. 60 HYGIENE OF THE VOICE. G-irls generally develop more rapidly than boys. They arrive at the age of puberty, and become old sooner. Hippocrates attributed this to their more delicate organism, and to their mode of living. We find also that a variety of causes influences the age of puberty ; the climate, for we find it earlier in warm than in cold climates ; the mode of living, for it is certain that puberty develops itself earlier among the wealthy than the poorer classes ; the theatre, the reading of novels, or any cause which, exciting the sensibility, provokes and accelerates the movements of nature. The transformation is not always easy, some- times being felt painfully, both in the physical and moral life of the woman. Yet sometimes it is effected in an almost inappreciable manner. The pitch lowers one or two notes, and the voice gains in strength what it has lost in acuteness. But if at that time she uses her voice much, she exposes herself to sore throat, or even loss of voice, occa- sioned by the exaggerated physiological work, which, at this time, the larynx is forced to un- dergo. As we have said, the change occurs later in boys than in girls. The young man knows not the pain- ful trials that await the young girl; he goes through the change almost unconsciously, except that the voice becomes modified. FORMATION OF THE VOICE. 61 These modifications vary very much as regards the sensible phenomena which they present, but there are two modifications common to all and entirely characteristic ; 1st, the modification of the timbre ; 2d, of the pitch. The timbre, which gave to the boys the singing qualities of the voice of the young girl, changes completely its character ; the pitch is sensibly low- ered, and little by little the voice acquires those qualities which distinguish the male voice. Some- times, about the age of 14 or 15, this alteration takes place insensibly, but more often, especially in those children who sing, it is accompanied by exaggerated manifestations of the change; the voice becomes harsh, and uneven; the boy loses the control of his vocal cords, and often emits a high note when he desires to sound a low one, or reversely, or even there is complete aphonia or loss of voice. The phenomena to which we have just alluded, do not follow any very regular order of develop- ment. Generally the voice does not fail all at once. It is veiled, sometimes hoarse, the hoarse- ness continuing during the whole period of the change of voice, and the pure timbre being re- gained only after the lapse of six months or a year. After a lapse of time, varying in different indi- viduals, the young pubescent has lost entirely his 62 HYGIENE OF THE VOICE. child's voice ; but that which he now possesses has not yet the strength, energy, timbre or pitch which are to characterize it ; it vacillates between what it has been and what it will be. This is due to the fact that the larynx has not yet acquired its full development ; the growth of that organ taking place slowly, and not being completed till 18 or 20. It may, then, be said, that the period of the change of voice in man varies from 3 to 5 years, and in woman 1 or 2 years less. It is not necessary that the young pubescent should stop singing as soon as vox rauca appears. Most music teachers are in the habit of suspending all exercises, and even forbid their pupils to sing at all. Although it is necessary to take the greatest precaution, lest the exercise should pro- duce a weakening of the vocal organs, and there- fore an arrest of development; nevertheless, I do not hold to the opinion of these masters ; but, on the contrary, I believe that the exercises should be continued, even during the vox rauca, always taking care to make the pubescents sing with the utmost caution, practising not more than a quar- ter of an hour a day, and confining the exercises within an octave and a half, making no attempt to produce either the highest or lowest note, which he could previously sing. Another general rule is, to study carefully the voice of the pupils, to FOKMATIOlsr OF THE VOICE. 63 observe every day the notes they have lost, or are not able to sing easily, and to take them off from their exercises. Finally, there will be an epoch of very short duration, when the compass of the voice is only an octave. During this time only would I advise a complete suspension of all vocal exercises. These may soon be resumed, proceeding gradually to add notes to the exercises in proportion as the voice gains in strength and range. If these rules are followed, instead of being in- terfered with, the physiological change of the voice will be hastened; the voice will be better devel- oped, will have more strength, a greater range and more suppleness than if left to itself. If, how- ever, hoarseness comes on at any time during the change of voice, all practice must be given up, and the pupil should be warned against all screaming, loud bursts of voice, or anything else tending to increase the irritation of the vocal membrane. After puberty, the larynx of the young woman continues to develop until she is 22 or 23 years of age, and that of the young man until the age of 24 or 25. The voice follows the development ; it insensibly acquires greater strength and range until the moment when the organ has ceased to grow. From that time, no further change takes place in the voice, except that produced by study and exercise. 64 HYGIENE OF THE VOICE. The remark of Dr. Fournie, that it is very dim- cult to determine the precise moment at which old age begins, will be found quite true, if we judge only from external appearances, for some persons possess the happy privilege of preserving all the outward signs of maturity, far beyond the ordi- nary limits. Years alone do not make the old man. It is rather the transformations taking place in the organism, one of the leading charac- teristics of which is the change occurring in the voice. The timbre loses its purity, the voice be- comes veiled, and the speech is slow, hesitating, and tremulous, on account of the alterations which have taken, and are still taking place in both the vocal and genital organs. In woman one of the distinctive phenomena is the greater or less amount of congestion which takes place, and which sometimes produces hoarse- ness, and always a lowering of the vocal pitch; the timbre of the voice changes little by little ; its soft sweetness disappears, and finally it becomes very similar to that of man. These modifications follow closely and seem to be connected with, if not dependent upon, the same causes which j)roduce the suppression of the menses. It seems as if nature having given to the voice of the girl power to express the part she is called to play in the great function of reproduc- FOEMATIOIT OF THE VOICE. 65 tion, wished to point out by this modification that her ability to perform her part no longer exists. The changes in the voice are dependent upon organic modification in the larynx. The mucous membrane lining it becomes of a more intense red- dish tint ; the circulation in the part is more ac- tive; and sometimes even polypoid growths are developed upon the vocal cords. These mem- branes always thicken, the cartilages become harder, and a sensation of uneasiness rather than of pain is experienced. These changes are not so strikingly manifested in man as in woman. Although there is often a perceptible hoarseness, the modifications follow each other so insensibly that they are scarcely no- ticed. Probably the first phenomena noticed are the growing weakness and lowering of the pitch of the voice; he can no longer produce all the notes he formerly could by the chest register, and remedies that want of power by the use of the fal- setto. CHAPTER V. REGISTERS OF THE VOICE. A great variety of opinions exists among sing- ers and teachers concerning the precise significa- tion of the term register. The human voice pre- sents in the same individual certain sonorous qual- ities differing greatly according to the degree of the vocal scale in which it is examined. To these varieties, the names chest, falsetto,* and mixed voice are generally given. Dr. Fournie's theory is by far the most philo- sophical ; it is the one we shall adopt. He consi- ders the three type voices, (chest, falsetto, and mixed,) as the result of the vibration of the same sonorous body, the mucous fold covering the in- * The terms chest and falsetto voice would seem to imply that the modifications of sounds to which those names are given are produced or resumed from the chest and arriere-gorge respectively. This is not bo. The names indicate the character and quality of the sound alone. The chest notes are produced by the ordinary mode of vibration ; the falsetto notes, which are purer and more fluty, are considered to be prob- ably due to vibrations of the harmonic subdivisions of the column of air in the trachea, or to vibrations of the inner borders of the vocal cords. REGISTERS OF THE VOICE. 67 ternal border of the chordae vocales, the difference between them being that in the production of each one, different lengths of the vocal membrane are set in vibration. This length is determined by the muscles of the parts. The chest voice depends upon two conditions for its production : 1st. In the simultaneous increase in length and thickness of the vocal cords. 2d. In modifications in length of the vibratile parts of the vocal membrane. This length is de- termined by the length of the glottis, which is shortened from behind forward in proportion as the tone rises. These conditions characterize the chest register only when they exist simultaneously; that is, for any given note, the lengths of the vocal cords, their thickness, and the length of the vocal membrane must be constant in the same indi- vidual. When the chest register is used, the transverse diameter of the glottis is small and linear, and the interior borders of the vocal cords which limit it are so thick and rigid that the air experiences a certain degree of difficulty in passing through the rima glottis, and setting the vocal membrane vi- brating ; but it is precisely this difficulty which gives to the chest voice, the strength, roundness, 68 HYGIENE OF THE VOICE. and energy which characterize it. We must re- member that the intensity of the sounds depends upon the amount of force with which the sonorous body is set in motion. The falsetto voice is found by : 1st. The shortening of the glottis from behind forward, so that the vocal reed is much shorter than during the production of the chest voice. This shortening is produced by the contraction of the lateral crico-arytenoides. It is also shortened from before backward by the contraction of the oblique and vertical fibres of the thyro-arytenoi- dean muscles. The action of these muscles is di- rect, it being produced by their thickening during contraction. The particular quality which distinguishes this register is dependent on the smallness of the reed which produces it, and is also due to the particular disposition of the different parts of the vocal pipe, of which we shall speak more at length when we treat of the timbre. The mixed voice is produced by : 1st. A very long glottis, extending the whole distance between the thyroid and the superior bor- der of the cricoid. 2d. A greater transverse diameter of the glottis than in the production of the other registers. This disposition of the parts results from the moderate KEGISTEKS OF THE VOICE. 69 tension exercised by the lateral crico-arytenoides and the thyro-arytenoides muscles. The mixed voice is not produced by all singers in the same way ; almost every one has his own manner, the result of the lessons he has received and the formation and disposition of his vocal or- gans. Very frequently it is used to produce high notes by those whose organs are not sufficiently cultivated, and who thus remedy their insufficiency by a forced tension of the parts. This register is a medium between the chest and falsetto, being softer than the former, but lacking the rich roundness which characterizes it. It is more sonorous, however, more far reaching than the falsetto. Singing masters do not all agree upon the exist- ence of this mixed register. Indeed, many con- sider it as nothing more than a diminished chest voice. But in a physiological point of view the mixed voice exists. Less painful to produce than the chest voice, it is also a period of rest for the singer. It is especially useful when the singer, having arrived at quite a high note, experiences some difficulty in producing new ones. However, the singer should endeavor to develop as much as possible the chest and falsetto registers, and to ob- tain by a suitable variation of the timbre and in- tensity of the sounds of these registers all the 70 HYGIENE OF THE VOICE. various tones which the human voice is capable of producing. Besides the chest, falsetto, and mixed voice we have also the so-called head voice, which is very often confounded with the falsetto. Let us see how it is formed. In studying the anatomy of the vocal apparatus we found that the isthmus of the throat, or pharynx, was formed by a contractile surface lined with mu- cous membrane. The anterior portion of this is bounded below by the base of the tongue, and above by the veil of the palate and uvula ; the two lateral walls being bounded by the pillars of the veil of the palate, and that in the recess or fossa between these pillars the tonsils were lodged ; besides which the nasal cavities were shown to communicate with the pharynx and with several cavities or sinuses in the bones of the face. Now in the production of sound the veil of the palate or soft palate, as it is indiscriminately termed, plays a very important part, for, being easily movable, we can by means of it increase or decrease the size of the vocal pipe. This decrease takes place progressively from the lowest to the high- est note. In fact, according to whether it rises or falls, the sonorous column of air is found to pass into the mouth or into the nasal fossae. During the emission of the head notes the soft palate comes REGISTEKS OF THE VOICE. 71 in contact with the base of the tongue, and the sound resounds in the naso-pharyngeal region. Hence the name of head voice. If, on the contrary, the soft palate is raised so as to close the posterior part of the nasal fossae, the column of air escapes entirely by the mouth. The phenomena of whistling appear to corre- spond nearly to those of the production of musical sounds. The lips, by the aid of their appropriate muscles, are brought into a state of tension anal- ogous to that of the vocal ligaments ; and the pas- sage of a current of air between them compels their surfaces to vibrate. The resonant cavity is the hollow of the mouth ; and the mechanical con- ditions for whistling differ from those for speak- ing in this respect, that the current of air for whistling passes from the resonant cavity to the vibrating lips. For producing their lowest note in whistling, the tongue is very far retracted, and the lower lip appears to be the same. The range of notes in whistling is greater than in singing. CHAPTER VI. TIMBRE OF THE VOICE. We have seen that the intensity or volume of sound depends upon the multitude of the vibra- tions of the sonorous body, and is measured by the amplitude of the vibration of the auditory nerves ; that the pitch depends upon the greater or less rapidity of these vibrations and the timbre or quality upon their form. Perhaps we had better say of the last that it is produced by the second- ary sounds which always accompany the principal one, and which, therefore, sets in motion accessory fibres of the vestibular nerves. A sound produced in. the larynx traverses a vo- cal pipe of extreme mobility, and, therefore, it is not only possible, but almost certain, that the sound produced is greatly modified both in its volume and its timbre or quality. The special timbre belonging to each individual depends upon the form, size, and particular state of the different parts of the vocal pipe. The smallest alteration in size, the slightest change in the condition of the parts, as that produced by an TIMBRE OF THE VOICE. 73 * inflammation of the mucous membrane, by the en- largement of the tonsils, by the plugging up of the nasal fossae, the loss of the teeth, or an affection of the veil of the palate, is sufficient to change imme- diately its natural character. The various shades of modification of which the voice in the same individual is capable, may be classed under the principal types ; the sombre tim- bre and the clear timbre. The sombre timbre results from the resounding of the voice in the vocal pipe, which is disposed in such a manner that the cavities are as large as possible and the orifices by which these cavities communicate with the external air are sufficiently diminished in size to oppose any obstacle to the free exit of the air contained in the vocal pipe : to understand clearly the formation of this timbre, we have only while pronouncing aloud the letter A (French), to approximate the lips little by little, as if we wished to pronounce the letter O, always sounding the same note ; we {perceive that the tim- bre loses in a measure its ringing quality, in other words it becomes sombre. This modification of the timbre results evidently from the narrowing of the buccal orifice, which imprisons the sound in the mouth, and, consequently, favors its resound- ing in that cavity, and from the fact that to pro- nounce the letter O, the mass of air inclosed in 4 74 HYGIENE OF THE VOICE. ♦ the pharyngeal canal is required to escape less rapidly than while pronouncing the letter A. The sombre is more musical than the clear tim- bre, and therefore produces a much more agreeable impression upon the ear, but it requires a well de- veloped chest and a very solid larynx to sing much with it. It is well adapted to the Italian lan- guage, and is, in fact, the one mostly in use among the singers of Southern Europe, since it is adapted especially to those languages where there is a pre- ponderance of vowel sounds. It is generally said that the French owe its in- troduction to Mr. Duprez, who with his sombre timbre had an immense success on his return from Italy. But its use in the English language would require a very considerable modification of the sounds of certain letters ; for as we have seen, in order to give to the voice the peculiar qualities characterizing this timbre, the buccal orifice must be made smaller than in the ordinary voice and the jaws approximated, as in the pronunciation of the letter O, so that the a of father in singing would resemble very much the o of other, and the a mfate, would be like e in her. Voices of a sombre timbre are easily fatigued. The laryngopharyngeal mucous membrane be- comes dry, and the vocal cords soon wear out. When this misfortune overtakes the singer, he has TIMBRE OF THE VOICE. 75 but one remedy, total and complete rest of his vocal organs. The clear timbre is diametrically opposed to the preceding as regards its sonorous qualities and its formation ; while in the sombre timbre the buccal orifice is slightly narrowed, in the clear timbre, the jaws are widely distended and the mouth open. The same is true with regard to the isth- mus of the throat, which, while it is narrowed in the sombre timbre, in order to enable the voice to resound in the pharynx, is, on the contrary, as large as possible in the clear timbre. The buccal and pharyngeal cavities undergo opposite modifi- cation in these timbres. In the sombre they are as large as possible ; in the clear they are a little narrower than in the ordinary voice. The sounds produced are also diametrically opposite ; for ex- ample, o is pronounced like a in mat, while the word her is sounded very much like hare. There is besides the sombre and clear timbres, what Dr. Fournie has so well described as the gut- tural timbre. The guttural timbre derives its quality from a too great narrowing of the isthmus of the throat, the arriere gorge of the French. This narrowing may be congenital, or may be produced by a swelling of the tonsils, or it may be the conse- quence of bad tuition. When the guttural or 76 IIYGIENE OF THE VOICE. throaty timbre is congenital, it may be remedied to a certain degree by a daily exercise, consisting of the production of laryngeal sounds without the apparent assistance of the muscles of the throat. To do this, execute vocal exercises in front of a looking-glass, keeping the tongue projected as far as possible out of the mouth, and let also the opening into the throat be as large as possible. The mirror will guide sufficiently in the execution of this exercise ; the pupil may also execute the vocal exercises upon the e of the word met, since the production of that sound necessitates the pro- pulsion of the tongue forward and a relaxation of the throat, modifications indispensable to the end desired. When the guttural timbre is owing to swollen tonsils, and this is generally the case, the sound is produced by the tonsils interfering with the con- traction of the veil of the palate, and, consequently, it is prevented from discharging one of its most important functions, namely, the occlusion of the nasal fossae. When this timbre is the result of neglect on the part of the teacher, it is perceived only during the emission of certain notes. It re- sults often from the great exertions singers make to reach very high notes. An exaggerated nar- rowing of the isthmus of the throat takes place during the production of those notes, and, no TIMBRE OF THE VOICE. 77 doubt, gives to tliera their guttural quality. But the voice loses iu sonorousness the little it gains in range. There is also a buccal and a nasal timbre. In vocalization — that is, in the production of the non- articulated voice — we may cause the sound to pass through the nose or the mouth. In this way we may produce the pure buccal and nasal timbres. The latter is muffled, it is somewhat weak and possesses but little volume. These characteristics are, no doubt, produced by the small size and the flattened form of the cavity in which the voice re- sounds. The buccal timbre is distinguished from the preceding by the greater intensity, brilliancy, and volume of the sound. Although it is possible to sing exclusively in either of these timbres, yet it is very rare that either one is exclusively used in vocalizing. Gen- erally in the production of the grave and medium notes, the sonorous waves escape from both mouth and nostrils, while in the formation of the high notes the sounds escape exclusively from the mouth. The timbre then possesses a peculiar ringing quality and a slight degree of harshness indicative of its origin. Skilful singers, however, modify or conceal altogether this bad quality by a peculiar disposition of the mouth, consisting of an increase in the size of the interior dimension, and 78 HYGIENE OF THE VOICE. a diminution of the buccal aperture. By these means they force the voice to resound within the buccal cavity and produce a timbre which softens that of the vocal reed. Besides the timbres already given, there is a peculiar quality belonging to and distinguishing each individual which he cannot modify, and poetically called by the Germans the color of the sound. This is of the greatest importance in musical art, since it furnishes to it one of its most powerful means of expression. Anger, pity, joy, grief, love, each modify the voice, and in so char- teristic a manner that even should the words escape us, the quality, the timbre of the sound alone would speak clearly. Fear and languor lower the voice ; surprise takes it away, anger renders its hoarse, admiration prolongs it, hope makes it sonorous, joy resounding. There are strong voices, the sounds of which are loud and powerful ; sweet voices, with flute-like tones ; fine voices, of which the timbre is always the same. There are voices exactly the reverse of these ; hard, veiled voices, whose sounds are rough and with- out any ringing quality, uneven voices where the fine sounds are unequally distributed, and coarse voices where the fine, even timbre is altogether wanting. The volume of the larynx is generally indepen- TIMBRE OF THE VOICE. 79 dent of stature ; tall men sometimes having small larynges, while some small men have very large ones. The form and consistency of the vocal organs, however, coincide generally with the phy- sical conformation and constitution of the individ- ual. Indeed, each person presents a conformation which is recognized almost as readily in a separate part as in the whole individual. It commonly happens that the man in whom the curved line predominates is corpulent, his bones but little de- veloped, the cellular tissue abundant, and all the angles well rounded. These characteristics or ap- pendages of the lymphatic-sanguineous tempera- ment are also strikingly shown in the organs of the voice, and give to them an appearance and consistency greatly resembling those of the female larynx. The prominence and depression produced by the thyroid cartilages in the front part of the neck are but slightly marked, the height of the larynx is comparatively small, the laryngeal cavity rounded, and the vocal cords, ordinarily very large, circum- scribe a very small glottis. These anatomical peculiarities give rise to a voice which is very sweet and high-pitched, called the Tenor, If, on the other hand, the straight line predomi- nates in the individual, if the angles of the body be well marked, and the cellular tissue small in 80 HYGIENE OF THE VOICE. amount, we shall find a well defined, salient angle, in the front of the neck (Adam's apple), a com- paratively great height of the alas of the thyroid- cartilages, and the laryngeal cavity greater in its antero-posterior diameter than the former one, will have a correspondingly greater length of the vocal cords. These are the characteristics of the Bass voice. This voice is generally met with in athletic individuals, and the organs of the voice develop harmoniously with the remainder of the body. The characteristics of the Baritone voice are midway between those belonging to the tenor and bass. If this voice is high-pitched, the character- istics will be analogous in character to the tenor ; if low, to the bass. Voices are generally divided into the following classes : — Female. Male. Soprano, Mezzo-Soprano, Contralto. Tenor, Baritone, Bass. This classification, based exclusively upon the pitch of the voice, answers well enough, perhaps, for the requirements of teaching, but as a scientific division seems incomplete, and based upon wholly insufficient grounds. In order that any classifica- tion of voice should rest upon sound principles, the TIMBRE OF THE VOICE. 81 divisions of voice should not only be determined by the pitch, but also by the timbre, the intensity and the volume — in short, by everything which distin- guishes one sound from another. It is evident that sounds are not sufficiently characterized by their high or low pitch ; for we see baritone sing- ers readily sing A and B, and tenor voices which sing A below. These notes, it is true, do not have the sonorous qualities which characterize the other tones of these singers. The something, the quid ignotwn, which distinguishes the A of the tenor from the A of the baritone, is due to the different timbre, intensity, and volume of the voice, in the tenor and baritone. These conditions are necessary to a full appre- ciation of any sound, and we find a reason for their necessity in the study of the vocal apparatus. If we take any note capable of being given by either a tenor or a baritone voice, the E in the fourth space for example, we find that since it is about the middle of his natural register, it will be produced by the tenor without effort, will have a natural and agreeable timbre, and will be both as intense and voluminous as possible, since, as the sound is moderately high, the glottis is open for nearly its entire length, and the resistance of the vocal membrane to the effort of the lungs is justly proportioned. The baritone emits the note with a 4* . 82 HYGIENE OF THE VOICE. degree of difficulty ; the timbre will not be like that of the tenor, since the vocal membrane is not as thin as in the tenor. The vocal membrane of the baritone is also longer, and to produce the same note a greater degree of tension is requisite, and this tension also modifies the timbre, while the intensity and volume may be the same in both cases. What has been said of the tenor and baritone applies also to the bass and the different female voices. The soprano is the highest female voice, extend- ing generally two octaves from C to C. The mezzo-soprano of woman is analogous to the baritone of man. Like the latter it unites the two extreme limits of the voice, and ranges generally from A to A. The contralto is the gravest of female voices. Generally extending from F to G, the contralto may be recognized by the character of the larynx, that organ being more voluminous than is usual in females. Its antero-posterior diameter is also lar- ger than the average, thus rendering the thyroid angle or Adam's apple more prominent. The male and female voices begin and end at different notes of the musical scale, as is shown by the following table. TIMBRE OF THE VOICE. 83 COMPARATIVE SCALE OP THE RANGES OP THE HUMAN VOJCE. mi. fa. sol. la. si. do. re. mi. fa. soli la. si. do. re. mi. fa. sol. la. si. dohre. mi. fa. sol. la. si. do. Mezzo Soprano. . The compass of the voice may be increased by exercise. This sometimes gives rise to an illusion, influencing the teacher and the pupil, relative to the power of cultivation to affect the natural lim- its of the voice. It is dangerous to attempt to transcend the natural capabilities of a voice, to de- sire to transform a baritone into a tenor, or a mez- zo-soprano into a contralto. The organ cannot be recreated, and the fatiguing effort only destroys its natural qualities. Exercise, by developing the voice, may add a few notes, but it cannot cause the cords to vibrate beyond or below their natu- ral elasticity. Therefore, so soon as one perceives that the ringing quality is lost, that the freshness and purity are diminished, it becomes, at once, 84 HYGIENE OF THE VOICE. necessary to abandon a method so opposed to the natural one. It is, specially, the abuse of the acute sounds which destroys the voice; and, from their first studies, the pupils are most frequently exposed to this danger, the teacher carrying the head or the chest tones too far. In the first instance he runs the risk of breaking the voice ; in the second, of destroying the medium, which remains thin, weak and veiled even when the head voice or the chest voice has its normal characteristics. The physical qualities necessary to an agree- able and powerful voice naturally find their place here. The voice may be acute or grave, sonorous or muffled, true or false. The low-pitched or grave voice results from a larynx which is short and whose inferior vocal cords are more lax, and at the same time of greater width, together with the peculiar shape that the vocal pipe is made to assume at the time of the emission of the note, while the high-pitched or acute voice is obviously the result of the very opposite conditions of the same organ. I may add that accumulation of mucus in the air-passages also influences the pitch of the voice. In this way we can explain why it is that in the morning the voice is always more grave ; it also accounts for TIMBRE OE THE VOICE. 85 the lowering of the pitch in those who take cold readily. The purity of the voice results from the ease with which the air is expelled from the lungs ; the precision with which the varying tensions of the vocal cords are made ; the absence of all obstacles to the passage of air through the bronchi, larynx, mouth and nasal fossae ; the condition of the mem- brane lining the vocal apparatus; the art with which the sonorous wave is modified in the buccal and nasal cavities before reaching the external air; and finally, the absence of all causes which might oppose the action of the expiratory and in- spiratory muscles, as well as those which move the larynx itself. There is another subject on which I am often consulted, and which from its importance needs careful consideration. We see daily people who, though having strong, sonorous and flexible voices, are yet unable to sing correctly ; this is popularly denominated " having no ear for music." Bennati's view of this subject is, that this inability is due to physical discord- ance between the ear and those organs which, hav- ing their seat in the larynx, produce and modify the voice. This discordance is a neuralgic trouble, arising from a want of proper harmonic relation between the actions performed by the vocal organs 86 HYGIENE OF THE VOICE. and those imposed by their action upon the audi- tory nerves. This explains why it is that people having strong and flexible voices, yet sing out of tune ; the defects of their voices, if there be any, are due to the form, the energy and disposition of the organs themselves, whilst a faulty intonation results from the fact, that the nervous system of the ear, since it does not coincide with the nervous system of the vocal apparatus, rests upon different relations to the sound produced, and is therefore affected in proportions which have an increasing tendency to disturb one another's action. Outwardly the ear presents but little to be no- ticed. The secret of its power lies in the most hidden portion. Anatomists for a long time stud- ied only those parts concerned in the transmission of the sonorous wave, to the fluid contained in the membranous labyrinth upon which the termina- tions of the auditory nerves are distributed. By the external auditory canal the sound reaches the tympanum, and thence by a very complicated path passes to the labyrinth; within this is inclosed the cochlea, where it plays upon the nervous key- board. This is formed by a spiral membrane of great delicacy, upon which the nerves are distri- buted, and which is bathed by a liquid within the small osseous cavern of the labyrinth. The mi- croscope has shown this membrane to be composed TIMBRE OF THE VOICE. 87 of about three thousand small fibres, the filaments of the acoustic nerves; the extreme delicacy of these nerves enables the ear to detect with won- derful facility the various sounds. Hence the conditions which must be fulfilled, in order that the voice may have a correct intona- tion, seem to be : First, that there shall be an apti- tude for music : secondly, that the cerebral sub- stance in which the sound is to be registered shall be in a normal condition ; thirdly, the absence of all lesions of the auditory nerve which transmit the sounds to the brain ; fourthly, absence of all grave affections of the ear ; fifthly, that the organs of the voice themselves must be in a perfectly healthy state; and sixthly, that the proper rela- tion of ear and voice shall exist. We meet constantly people whose auditory and vocal apparatus are perfect, but in whom there is a lack of musical aj)titude ; so also we sometimes meet with people who have been noted for the ex- cellence of their voice, the acuity of their ear, and who have lost the latter power from an inflamma- tion of the internal or middle ear, or a local apo- plexy ; often they recover it with the cure of the trouble. There is another class, who understand thoroughly all that harmony requires, yet are un- able, on account of hoarseness, or of an ulceration of the throat, to give to each note its proper into- 88 HYGIENE OF THE VOICE. nation. The difficulty may also arise from a dis- cordance between the pitch of the sound, the ener- gy of the modifying organs, and the volume and rapidity of the breathing. The falsity of the voice, however, is very often more apparent than real, and, though often incura- ble, it may sometimes be removed ; but the manner of doing this must necessarily vary, according to the cause of the difficulty. This, however, con- cerns the master more than the pupil. CHAPTEE VII PHYSIOGNOMY OF THE VOICE. The ability to utter sounds is not confined to man alone ; many creatures share this power with him, and such special and peculiar sound has, gen- erally, its characteristic designation. Thus we say, the dog barks, the horse neighs, the sparrow chirps, the owl hoots, the duck quacks, the pig grunts, the lion roars ; we speak of the buzzing of insects, the gabbling of geese, the croaking of frogs. To man alone, however, belongs the full power of complete expression through the voice — of speech — of imitation. But, whatever may be his aptitude for imitation, his study, his perseverance, he never can succeed in completely changing its character. The natural individuality of the voice will still be apparent. We see this illustrated in persons of different temperaments : each man pos- sessing a peculiar tone or timbre of voice equally as indicative of character as each feature of the face. This timbre or quality of tone may be appropri- ately termed the physiognomy of the voice, or, in 90 H¥(*1E.NE OF THE VOICE. other words, the revelation through sound of the inner man. Socrates divined the quality of man's mind or soul by the tone of his voice. This great philosopher, on one occasion, beautifully and elo- quently exclaimed : " Speak, that I may see you ! " We perceive in a stutterer one that is easily en- raged, and as easily pacified, vain, officious, incon- stant, and ordinarily quick. A person whose utterance is thick and coarse is malicious, cunning, and disdainful. A coarse voice indicates a robust physique, a great talker, quick-tempered, though conspicuously discreet. A piercing, fine or weak voice is indicative of timidity, cunning, and generally of quick wit. An attractive and clear voice expresses a man who is prudent, sincere, and ingenuous, but proud and incredulous; whereas a firm voice, without harshness, denotes a person who is robust, intelli- gent, circumspect, and benevolent. A man possessing a trembling and hesitating voice is timid, weak, vain, and sometimes jealous. A voice combining great sound and firmness in- dicates a man who is strong, audacious, rash, obsti- nate, and self-important. A sharp and rude voice, in singing as well as in conversation, denotes a coarse mind, inferior judg- ment, and strong appetites, PHYSIOGNOMY OP THE VOICE. 91 A hoarse voice, seemingly the effect of a cold, signifies a person more sinrple than wise, credu- lous and untruthful, vain and inconstant. A full and sweet voice denotes a man who is peaceful, inclined to timidity, discreet and self- willed. A voice at first grave and then sharp and pierc- ing denotes the quick temper of an impetuous, arro- gant, and impudent man. A soft, sweet voice is found in a person of a peaceable, ingenious, penetrating, and subtile char- acter. Each passion has also a tone of voice which dis- tinguishes it. For example : Anger is expressed by a sharp, animated, and frequently interrupted voice. Fear, by a submissive, uncertain, and troubled voice. Indignation, by a hard, terrible, and impetuous tone. Grief, by a moaning, pitiful, and sobbing utter- ance. Love, by a sweet, tender voice, interrupted by sighs. There are likewise as many inflections of voice as there are shades of sentiment, all susceptible of combination, but the timbre is always in keeping with the character of each individual. 92 HYGIENE OF THE VOICE. Therefore, an enraged man has a blunt, unsteady voice, while a mild man is gifted with a voice analogous to his character. A serious and* pensive man speaks seldom, his tone is grave, his utterance being measured by the signification of his words. The thoughtless and inconstant person prattles unceasingly, and is continually changing his tone and theme of conversation. A man of bilious temperament utters his words briefly and rapidly ; the words of a man of nerv- ous temperament are sometimes uttered with ex- travagant rapidity. A phlegmatic person, on the contrary, expresses himself slowly and sometimes in a drawling tone. The voice accompanying the sanguine tempera- ment is clear, sonorous, light and petulant. Fine development of the vocal organs is usually found in a person of sound physical organization. The voice of a melancholy person is dry, sepul- chral, and deeply impressive. The naturally good man, for instance the phi- lanthropist, expresses himself in a sweet, enticing voice. The reverse is observed in a naturally bad man ; his voice is dry, harsh, and disagreeable. The presumptuous individual expresses himself in a boasting tone, is sarcastic and derisive ; always wishing to produce an effect and to eclipse others. PHYSIOGNOMY OF THE VOICE. \)6 A modest man is simple and measured in his lan- guage. The hypocrite is always false ; under the mask of sincerity he seeks to entrap by his dangerous insinuations. The flatterer is known by his soft and honeyed speech, by the elastic yielding of his language, adapting it to all forms, and reflecting all shades of thought. An idiot emits a heavy, drawling sound, without any harmonious inflections. The man of genius is known by his quick and powerful accentuation. The enthusiasm which boils in his heart comes burning to his lips, and finds vent in his words ; his energetic and brilliant diction seizes and sways his hearers, and they are carried away by his eloquence. Man can, to a certain extent, apparently change his voice ; but, no matter how faithfully he may persevere, he never can effect a complete change. For instance, two persons, a man and woman, being constantly together, may assume the same intonation in ordinary conversation ; this will quickly disappear under the influence of anger or other strong emotions, and each will assume his or her timbre or peculiar tone of voice. CHAPTER VIII. RESPIRATION. Physiology teaches us that all animals live by the constant destruction and as constant renewal of their tissue, and that in order to remove the wasted products of destruction, certain excretory- organs are provided. The lungs are perhaps the most important of these, for by the acts of inspi- ration the oxygen necessary for carrying on the change is introduced, and the products of combus- tion, water, carbonic acid gas, etc., amounting in all to about one-half the waste of the system, are removed. By the contraction and expansion of the chest, and the arching or flattening of the diaphragm, the motions of which the lungs follow, a portion of the altered contents of the pulmonary reser- voirs is first expelled, and then a new supply of air introduced to undergo change in its turn, and as the lungs are never completely emptied, this change goes on constantly. The movements of respiration are divided into KESPIRATIOK. 95 two classes : 1st, those of inspiration, and 2d, those of expiration. By inspiration is meant the act of introducing air into the lungs; this is accomplished by the movements of the ribs from downward upward, from inward outward, and by the flattening of the diaphragm, a large muscle separating the cavity of the chest from that of the abdomen. It is di- vided into three stages: 1st, FlG 8 the mechanical, which con- sists in the introduction of air into the trachea and the larger bronchi; 2d, the dif- fusion of gases among each, by which air is introduced in the capillary bronchi and air- cells, and the foul gases pass outward ; and 3d, the diffusion of gases through membranes, by which the oxygen reaches the blood, and carbonic acid gas and water are given off. An experimental illustra- tion of the manner in which the air is introduced into the cavity of the lungs by the descent of the floor of the chest, and then expelled by its elevation, is represented in Fig. 8, in which 96 HYGIENE OF THE VOICE. a a is a tube of glass half an inch or more in diam- eter, and six or eight inches long, to the lower end of which a bladder, b, is tightly attached. The tube is passed through the neck of a bell-jar, c c, air-tight. A large glass reservoir of water, filled to the height d d, receives the bell-jar, as shown in the figure. When the jar is depressed in the water the air is expelled from the bladder, and when the jar is raised the air flows in. By alter- nately elevating and depressing the bell, the blad- der executes movements like those of the lungs, of which, indeed, it is a representation ; the glass tube being the trachea, the bell-jar the walls of tiie chest, and the rising and falling water-level the rising and falling diaphragm. In this illus- tration the bladder is, of course, perfectly passive, as was at one time supposed to be the case with the lungs. The air introduced into the chest loses very rapidly the qualities which made it fit for inspiration. Some of its oxygen combines with the carbon of the tissues and forms carbonic acid. The cause of the circulation of the blood through the lungs — the pressure of oxygen in them — being absent, this circulation stops, and the second act of respiration, expiration, becomes an immediate necessity of existence. By expiration is meant the act of expelling the altered air from the lungs and air-passages, and is EESPIEATION. 97 the exact reverse of inspiration. The stages are — 1st, diffusion through membranes ; 2d, diffusion of gases amongst each other ; 3d, mechanical. It is produced by the lowering of the ribs and the rising of the diaphragm. In ordinary tranquil respiration, the contraction and dilatation of the chest is effected almost en- tirely by the diaphragm, aided by the elasticity of the muscles of the abdomen, the movements of the ribs being almost imperceptible ; but in the breath- ing necessary to singing or speaking, the walls of the thoracic cavity take an active part. Formed chiefly by the ribs, which are arched symmetri- cally between the vertebral column, or backbone, and the sternum, or breastbone, and movable on account of their cartilaginous union with those bones, they act on the lungs, by their elevation or depression, in the same manner as the sides of a bellows, and by their simultaneous movements produce a dilation or contraction of the thoracic cavity, and so fill or empty the lungs. On ac- count of the manner in which the intercostal muscles are attached, the movements of the ribs increase rapidly from the first to the last, so that the eleventh and twelfth have ten to eleven times the mobility of the second. The respiratory movements are partly volun- tary, partly involuntary. Partly voluntary in 98 HYGIENE OF THE VOICE. order that they may be subservient to the purposes of singing, speaking, or the necessities of such labor as produces a rapid destruction of the tis- sues of the system, and demands as rapid a re- moval ; partly involuntary, lest in sleep, or in a moment of forgetful ness, the movements of respi- ration should be suspended, and fatal consequences ensue. The capacity of the chest varies greatly in dif- ferent individuals, and bears a constant relation to the height of the individual. But the size of the chest is no criterion as to the capacity for inspira- tion or expiration, which is the only accurate method of determining the development of the lungs. On an average, some 16 or 17 inspiratory movements occur in a minute, and in an adult of average size, we may assume, according to the ex- periments of Mr. Coathupe, that about 266J- cubic feet or 460,224 cubic inches of air pass through the lungs in 24 hours. Beckoning the average number of expirations at 16 per minute, this would give about 20 cubic inches of air expired at each. The experiments of Dr. Draper, which were conducted with great care, and from which the er- ror of time was eliminated, each experiment being carried on for 20 minutes, give 16 as the number of inspirations per minute, and 38.8 cubic inches of air as the average inspiration ; — the least RESPIRATION. 99 amount sufficing for the wants of the system, 511 cubic inches, the greatest capacity of lungs, 1077 cubic inches ; and that the amount of air intro- duced depends for the most part on the rapidity of respiration. Several circumstances may modify the capacity of the chest and diminish the quantity of inspired air. Tightly fitting clothes may so oppose the di- latation of the chest that a woman who, when laced up, can only respire 90 cubic inches of air, respires 170 when freed from the corset. The capacity of the lung diminishes also in pro- portion to the flattening of the body. It is less also in disease than in health. " Besides the movements of exj:>ansion and con- traction described above, belonging to the chest, there are similar respiratory movements taking place in the larynx. While respiration is going on there is a constant and regular movement of the vocal cords synchronous with the inspiratory and expiratory movements of the chest, by which the size of the glottis is alternately enlarged and diminished. At every respiration the glottis opens and allows the air to pass freely into the trachea ; at every expiration it collapses and the air is driven out through it from below. These movements are called the ' respiratory movements of the glottis.' They correspond in every respect 100 HYGIENE OF THE VOICE. with those of the chest, and are excited or retarded by similar causes." (Dalton, p. 24:0.) During inspiration the tongue and os hyoid are thrown backward, the epiglottis straightens from behind forward, the larynx descends, the lips of the glottis are carried outward by the separation of the arytenoid cartilage, and the trachea is shortened and widened. During expiration the reverse of all these movements takes place ; the tongue and hyoid bone being carried forward, the larynx ascending and narrowing, the lips of the glottis approximating, and the trachea narrow- ing and lengthening. The peculiar art of speakers, and of singers es- pecially, consists in a great measure in the proper management of the respiratory apparatus. If we abandon ourselves to instinct, we all respire equally well. Respiration is not then a thing to be learned, but when the will intervenes, as in singing or speech, it may happen that one of those means may be exaggerated to the prejudice of another ; in such a case we should strive to return to the normal type of breathing, or at least to use that type which is best suited to produce the desired effect. The names of costal, diaphragmatic, and ventral respiration, are just so many distinctions which puzzle both singer and speaker ; the truth RESPIRATION. 101 being that to respire well and naturally, the ribs, diaphragm, and abdominal muscles must each do its appropriate work, and as Dr. Fournie justly observes, " he who respires exclusively by one or the other of these alone, must be a sick man." Many of the faults of the singer or speaker are imputed to weakness of the voice, when, in fact, they are caused by a bad method of breathing — the singer either not taking breath at the right time, or not often enough, or not long enough. Some contract the muscles of the body so power* fully that they disturb the action of the respi- ratory muscles. Is it at all surprising, when the singer attempts to move so many muscles at the same time, that one set should act but imper- fectly ? This person cannot recite or sing for even a few moments without his mouth and throat be- coming dry and irritated ; it is, possibly, because he does not breathe methodically. That one de- sires to utter a voluminous sound, and fails miser- ably, because he has not filled his lungs sufficiently. Another, in order to breathe, presses with all his force uj3on the floor, contracts as far as he is able, the muscles of his extremities, and thus attempts to impart energy to his voice ; the result, com- monly, is the opposite of the one sought. Let the singer or speaker breathe naturally, and abstain from all unnecessary and injurious efforts, which 102 HYGIENE OF THE VOICE. only disturb those parts which carry on respira- tion. In singing, especially, a skilful use of the respi- ratory apparatus is demanded ; it does not consist in the use of any one j>articular method of breath- ing, but the singer should study, — 1st, to develop a natural respiration — 2d, to learn above all to respire in a manner best suited to produce the de- sired effect — and 3d, to fill the lungs as completely as possible at each inspiration ; for if the lungs be but partially filled each time, it will necessitate a frequent repetition of the respiratory movements, which will interrupt the singing in a very disagree- able manner, and render it anything but pleasant. When after an ordinary expiration the ribs have been lowered and the diaphragm has re- turned to its normal situation, there yet remains a little air in the lungs which allows of a still further prolongation of the expiration. To pro- duce this prolonged expiration the abdominal mus- cles are called into action. They effect it by com- pressing the anterior and lateral walls of the ab- dominal cavity, diminishing its diameter, and so pushing up the organs contained in it toward the thoracic cavity, forcing up the diaphragm, and thus expelling almost completely the air contained in the lungs. It is to this method of respiration that the name of abdominal has been given. RESPIRATION. 103 The voice may be greatly modified and im- proved by the natural or acquired possession of a prolonged inspiration and a methodic expiration. This consists in a deep inspiration, which will fill the lungs to their greatest capacity, taking the pre- caution of not aspirating when breathing. In the execution of a piece of music, the inspira- tions, always deep, must be slow or fast, according to the character of the music and the manner in which its phrases are divided. Thus during the rest or the half rest, the inspiration may be slow, while in a musical phrase divided by semi-quaver or demi-semi-quaver rests, it must take place rap- idly. In all cases, however, it is necessary to be guided in the depth of the inspiration by the length of the musical jDhrase to be emitted, in order to have a sufficient quantity of air to produce per- fectly each note, and to avoid exhausting the lungs completely of air before the musical phrase is ended, or a rest of some kind is reached that will allow of a new inspiration. It is even necessary that a certain amount of air is always held in re- serve in the lungs after the execution of each pe- riod; in this way the final note will always be given with greater precision, and the voice will be much more sonorous. It is by the application of these principles that great artists give to the voice an extraordinary range, and succeed in renewing 104 HYGIENE OF THE YOICE. the air in the lungs at certain points of very long passages. Habit and taste will alone enable one to determine the precise moment, when without in- jury to the musical effect, and sometimes without its being even perceived, that inspiration may be effected. CHAPTER IX. ALIMENTATION. To live, it is necessary not only to have received life, but also to maintain it. The condition upon which nature has given man life is, that he shall repair the waste of its force, by means of the ma- terials which she gives him for that purpose, to convert into his own substance. It is not enough to live, but to fulfil our part we must live long, and enjoy good health ; to do this, we must have a sufficiency of well-chosen aliments — in other words, man lives only by a constant destruction and as constant a reparation of his tissues. We have seen that fully one-half this waste or burning of the body is accomplished by the air introduced into the lungs, consequently the greater the amount of air respired the greater the waste. No one can sing much or read much without a great increase in the waste, which can only be repaired by food, to form new tissue. Thus we see that the stomach is almost as essential to singing and reading as the larynx or lungs. "There is amongst singers," says Mr. Segond, 106 HYGIENE OF THE VOICE. "a prejudice concerning alimentation. A great many of them expect to find in a frugal diet a sure guarantee against the alterations of the voice, but when the singer perceives that in breathing he burns his own substance, and that the reparation is made by alimentation only, he will understand that breathing much more than the man who does not sing, he must repair his enormous losses by a diet of the most nutritious character. Then and " then only " living in a perfect equilibrium he will preserve his voice in its strength and compass, and no longer be exposed to the numerous and severe disorders of the vocal apparatus which de- velop themselves so quickly in an exhausted or- ganism. We have seen that an adult in good health makes on an average 17 inspirations in a minute, and inhales from 17 to 20 cubic inches of air in each inspiration, that is from 10 to 12 cubic feet per hour, or from 240 to 280 cubic feet in 24 hours. Yet these amounts, enormous as they seem, are far less than those required for the respiration of the singer. Unable to deliver long musical phrases without respiring deeply, he accustoms his lungs to contain the greatest possible quantity of air. Dr. Draper's experiments upon respiration are of importance in this connection. His result may be thus tabulated. ALIMENTATION. 107 No. of Respirations No. of Cubic Inches per minute. per minute. 6 Least amount sufficing for the wants of the system, . . .511 16 Average demand, . . .622 33 Utmost extent of respiratory system, 1077 From which he concludes : 1st. Amount of air in each normal respiration is 38.8 cubic inches, the number of respiratory acts being 16 per minute. 2d. The amount of air introduced into the sys- tem depends for the most part upon the rapidity with which respiration is carried on. From this we conclude that the ordinary quan- tity expired by the singer when vocalizing — even if he makes but 10 respirations per minute — can- not be less than 800 cubic inches per minute. Here we have 3 times the amount of air respired normally, and heoce in no other physiological state have we the respiration so much exaggerated as in siuging. The oxygen which was introduced into the economy by the act of respiration, has in a great measure been converted into carbonic acid by the chemical changes taking place in the body, and is expired in this form. The carbonic acid gas expired varies with the 108 HYGIENE OP THE VOICE. age, constitution, food, state of health, hour of the day, paratus are most free and effective ; the larynx, by the erect position of the head, is carried forward ; the arytenoid cartilages are also so j)laced that a slight tension of the vocal cords is produced, so that everything in this posi- tion conduces to the formation of clear and harmo- nious sounds. We have already spoken of the compression of the neck. Let, therefore, the dress of singers be loose, so that too great a flow of blood to these parts shall not be produced. 7 146 HYGIENE OF THE VOICE. The singer, on account of the great amount of labor which his lungs are called upon to perform, might with benefit to himself abstain from all vio- lent exercise, such as running fast, loud reading, etc. He should remember that the lungs already perform almost all the work which they are capa- ble of doing, and not endanger his voice, if not his life, by taxing them unnecessarily. The intensity of the sounds produced by the vocal apparatus depends on the force with which the air is expelled from the chest, and the amount of vibration impressed on the larynx. It is only necessary that the respiratory and vocal organs should be placed in a perfectly normal condition, and that the chest should be of sufficient capacity, in order that the voice may be strong and pos- sessed of ail the natural qualities belonging to pho- nation. If it is true that the slightest alteration in the health of an individual instantly modifies the in- tensity of his voice, it is also true that his physi- cal strength contributes but very little to the for- mation of sound. As, in order to learn to play on any musical in- strument, continued practice is necessary ; so, in order to use the vocal instrument correctly, a proper exercise of the lungs is indispensable, since the singer must be able not only to provide an ample PRESERVATION OF THE VOICE, 147 supply of air, but must also be able to utilize it to the greatest possible degree. From the fact that iu singing the respiration is more ample than it is in speaking, three consequences result : 1st. By well-directed, systematic exercises in singing, the lungs acquire the power to retain a greater quantity of air for longer periods of time. 2d. The increased vigor and activity of the res- piration, little by little, augments the capacity of the lungs, renders them less liable to disease, and proportionally develops the thoracic cavity. 3d. Since the passage of the blood through the lungs from and to the heart is now rendered easier, the circulation becomes stronger and more regular. The power and elasticity of the lungs may be developed to a wonderful degree by a very simple exercise. This consists of four jDarts, which should be successively and perseveringly practised ; they are : 1st. To inspire as slowly as possible until the lungs are filled as completely as they can be. 2d. To expire the air so introduced with the same, or even a greater degree of slowness. 3d. To fill the lungs with air, and retain them so filled during as' long a time as possible. 4th. To empty the lungs as completely as possi- ble, and retain them in that condition as long as the strength will permit. 148 HYGIENE OF THE VOICE. These exercises, which will be found very fatigu- ing at first, should be executed separately, allow- ing quite an interval to elapse between any two of them, so that the lungs may not be taxed too greatly. The first two, viz., the slow inspiration and expiration, can be executed with greater ease and regularity if the mouth be almost closed, so that a very small opening only is made for the passage of air. The objection sometimes urged against this method of breathing, as being antagonistic to the natural method through the nose, is soon shown by experience to be without foundation : after a few deep artificial inspirations and expirations through the mouth, the breathing through the nose becomes fuller and more perfect. Before closing this chapter, let us return again to what we have said of singing as a hygienic means. From the manner in which the singer is com- pelled to breathe, the lungs are often filled com- pletely with air, and thus the lungs increase in volume ; the trachea and the osseous walls of the chest also partake of this development; the voice gains in volume and strength ; the circulation be- comes more active and the functions of the various organs of the body are thus better performed than before. Provided, then, that we violate none of the laws which are necessary to our well-being, a PRESERVATION OF THE VOICE. 149 moderate use of the vocal organs tends to maintain the general health, or even sometimes to promote it. Very frequently it has happened that a narrow chest has acquired a happy development through the judicious and continued exercise of the vocal organs. But the singer must bear in mind that singing has its disadvantages as well as its advantages. He should never forget that if the singing be kept up for too long a time, or be repeated at very short intervals, the continued movements to which it gives rise may act injuriously, not only upon the larynx, but also upon the organs contained in the thoracic and abdominal cavities. The list of diffi- culties which may be brought on by an immoder- ate exercise of the vocal organs is long. First in the order of frequency, we must notice hoarseness and dryness of the throat, due to the exhaustion of saliva ; a sensation of prickling in the larynx ; a more or less diminution in the range of the voice, or sometimes a change in its timbre, caused by a lesion of the larynx; laryngeal phthisis, or throat co?isumption 1 & deposit of tubercles in its coverings ; oedema of the glottis, or serous infiltra- tion of those parts of the larynx especially con- cerned in the formation of the voice ; finally, con- sumption itself may be the effect of the great labor entailed upon the lungs. 150 HYGIENE OF THE VOICE. Sometimes the production of very high notes re- quires considerable efforts, which cause the blood to ascend too violently to the face ; congestion and cerebral hemorrhage have at times followed. The lungs, during the acts of singing or declamation, are unable to properly aerate the blood, on account of the constant action they are called upon to per- form. It results from this that the blood is no longer oxygenated, and therefore tends to accumu- late in the nearest blood-vessels, fills beyond meas- ure the cavities of the heart, and predisposes to aneurismal dilatations. These results of excessive use of the vocal or- gans show how careful and moderate an exercise should be allowed to people subject to hemorrhages from the organs of the chest or inflammation of the organs contained therein, while singing should be entirely forbidden to those suffering from con- sumption or heart-disease, lest it aggravate their trouble. Our last hygienic measure, and a very import- ant one, is that the moment the singer is troubled with a short, dry cough, a profuse expectoration, a gradual loss of flesh, or spitting of blood, it be- hooves him to cease singing, in order that by giv- ing his overtasked organs rest, he may allow them an oppportunity of recovering their strength, and he, himself, his health, CHAPTEE XII. DISEASES OF THE VOICE. SORE THROAT Under the generic name of sore throat are classed affections of the pharynx, the tonsils, the uvula, the soft palate, and the larynx. It would be out of place in these pages to treat of that form of sore throat characterized by exuda- tion ; — croup, true or false, diphtheria, — or of the specific sore throat, whether tuberculous, cancer- ous, or syphilitic. Still more so would it be to discuss the exanthematous. CATARRH. A. Cold in the head. — One of the most common complaints of our climate is a " cold." Exposure to cold air, to dampness, and to draughts are among the* principal causes of this affection. A sudden lowering of the temperature ■ — a few degrees only — by cooling the skin of the feet, chest, or neck, the mucous membranes of the nose or of throat, is sufficient to produce this trouble, 152 HYGIENE OF THE VOICE. commonly designated as the effect of " checking the perspiration." The symptoms of a cold are well known. Fol- lowing the lowering of the temperature of the body — sometimes so slight or so gradual that we are unable to say when or where it occurred — there comes a feeling of lassitude ; we are dull, heavy; there is a sensation of fatigue, perhaps of stiffness like that which follows physical over- exertion; a disposition to shiver, and a slight headache. Thus matters remain for two or three days ; there is no cough as yet ; the secretion from the nose has become abundant and trouble- some, and sneezing now follows ; the eyes are very sensitive to light, and filled with tears, and there is a feeling of stupidity. Later on, the inflamma- tion may pass downwards to the chest, and then we have a decided cold. The duration of a cold usually varies from five to eight days ; it may, however, last fifteen to twenty, or even become chronic, and until the pitu- itary membrane returns to something like its nor- mal state the sufferer tries to content himself with slops. There are, however, many ways of shortening the duration of a cold. When the attack is not very severe, it usually suffices to inhale the fumes of strong tincture of DISEASES OF THE VOICE. 153 iodine, or snuff jDOwclered camphor, or to inject into the nostrils a weak solution of opium, at the same time taking a hot foot-bath to which some salt or mustard has been added. Emollient drinks are also useful, and at bedtime a sudorific in the shape of a hot punch or a Dover powder (ten grains), or the latter combined with sulphate of quinine, to tone up the system. The stiffness or soreness of the back may be relieved by a large sinapism between the shoulders. The persons most liable to suffer from colds are those who are naturally of weak constitution, or whose circulation is so languid that their feet and hands are almost constantly cold. In some this condition is so marked that one attack of cold seems only to prepare the way for a more severe one. As one of the chief, if not the chief cause of colds is a lowering of the general temperature of the body through the action of cold upon the skin, much may be accomplished by proper atten- tion to the skin, so as to render it less susceptible to such influence. Confinement in hot rooms or an excess of clothing does more harm than good. Exercise in the open air, covering the throat only when absolutely necessary, and the free use of the cold shower-bath, are among the best preventives. Of course delicate persons cannot at once use the cold shower ; it is too severe for them, and 7* 154 HYGIENE OF THE VOICE. would do more harm than good ; but they can be- gin by sponging the body with tepid water, grad- ually accustoming themselves to the use of colder and colder spongings, until they can use the shower with pleasure and profit. Wearing flannel next the skin, avoiding heated rooms and sudden transitions from heat to cold, cannot be too strongly insisted on. B. Chronic catarrh or coryza is a persistent inflammation of the nasal fossae, often due to, and following a cold in the head, which has not been completely cured. Sometimes it is developed de novo ; in that case it is the result of the continued action of the same causes which produce the acute form, such as exposure to cold, wind, or rain : at other times it is owing to the presence of irritating substances, such as tobacco-smoke, or various va- pors in the atmosphere habitually breathed. The chief symptom of chronic coryza is snuf- fling. The nose seems to be full, and there is a vain attempt to clear from it the obstructing sub- stance, which not only interferes with respiration, but with the sense of smell also, and alters the tone of the voice, rendering it more or less nasal. There is no special pain or uneasiness attending it, except the sensation of weight and fullness in the nose. The secretion of the nasal mucous mem- brane is always altered, though in different ways. DISEASES OF THE VOICE. 155 Sometimes it is abundant, thick, yellow or green- ish, resembling pus; at other times it is less in amount, and consists of hard, dry masses, firmly adhering to the nasal walls. In such cases it re- mains there for some time, undergoes decomposi- tion, thus giving rise to quite an offensive odor. This is the variety which gives occasion to the dis- agreeable hawking and spitting. Or, the secretion may be thin, salty, and extremely irritating ; spread- ing over the wings of the nose and upon the upper lip, it chafes and inflames them. Lastly, the secretion may be a clear, transparent, bland fluid, but so abundant that the nose becomes for the time being a small fountain. To this form the name rhinorrhoea has been given. Whatever may be the form of the discharge, chronic coryza is always a most obstinate and in- tractable disease, requiring vigorous and continued treatment for its complete cure. C. Ozcena is a disease of the nasal cavity, known mostly from the offensive nature of the discharge. It is an affection equally painful to the one at- tacked and to those who are obliged to remain in his vicinity. It is an ulceration of the nasal mucous membrane, or caries of the bones forming or supporting the framework of the nose. The caries or ulcerations in the nasal fossae form deep and irregular excavations, containing pus and 156 HYGIENE OF THE VOICE. broken-down tissue, which, decomposing, gives rise to the horribly fetid odor. It is almost invariably dependent on scrofula or syphilis. In addition to the characteristic odor, the suf- ferer from ozsena usually presents the symptoms of chronic coryza ; he snuffles, has a disagreeable nasal tone of voice, and his sense of smell is blunted, sometimes entirely lost. One other symp- tom, which, taken in connection with the odor, serves to characterize this disease, is the destruc- tion of the nasal bones, and the resulting defor- mity. Sometimes the two nostrils communicate by an opening through their septum or partition ; at other times the roof of the mouth is pierced, so that nose and mouth communicate directly, while again the bones forming the framework or support of the softer tissues, and which give form to the nose, may be attacked so that the nose is depressed, turned to one side, or even completely flattened. Once established, ozsena never undergoes a spon- taneous cure, but is now better, now worse, de- pending on the partial healing — specially during summer months — of old, or the development of new spots of ulceration. The necessity for care- ful, persistent, and vigorous treatment is easily understood. DISEASES OF THE VOICE. 157 INFLAMED SORE THROAT. As we have seen in the preceding pages, a very slight cause may determine a sore throat. Passing from a well heated ball-room or theatre to the ex- terior air without taking the precaution to cover the body sufficiently ; getting the feet wet or chilled ; remaining for a few minutes in a damp room ; forgetting the use of a purge long indulged in ; the suppression of menstrual or hemorrhoidal discharges, or of perspiration, especially of the feet ; the fatigue produced by reading, singing, or declaiming; the use of iced drinks, of irritating food, such as pepper, cloves, dry fruit, nuts, al- monds, etc. ; indulging in strong liquors, or finally an hereditary disposition — are all predisposing or determining causes of inflammatory sore throat. If the mucous membrane of the throat is irri- tated or inflamed, it becomes swollen, thickened, and congested. The calibre of the vocal pipe is diminished, and hoarseness results. The dryness of the throat is soon succeeded by a more or less abundant secretion from the mucous membrane, expectoration follows, and ceases only when the inflammation subsides. Sometimes the inflamed state extends to the neighboring parts, and all the mucous membranes, bronchial, laryngeal, nasal, that of the tonsils and velum palati, may be in- 158 HYGIENE OF THE VOICE. volved. When this occurs, the grave nature of the affection imperatively demands an immediate and energetic antiphlogistic treatment. But generally the inflammation is restricted to the uvula and the tonsils. When the latter are in- volved, they may become greatly enlarged so as to interfere with or even render deglutition almost impracticable. The accurate articulation of words becomes impossible, and even respiration is carried on with great difficulty, so that often the patient for the moment is unable to inspire at all. If the uvula is involved, liquids are more difficult to swallow than solids, and the grievous state of the sufferer is rendered still more so by the continued efforts to swallow provoked by the uvula tickling the base of the tongue. The uvula, commonly called the palate, is sus- pended in the central portion of the veil or arch of the palate forming an integral part of it. Its functions are : (1) to aid in the straightening of the veil of the palate ; the fleshy fibres of which it is mostly made up allowing it to contract com- pletely upon itself, and so to carry the veil of the palate upward. It also aids in drawing the pillars closer to each other in the median line. (2) At the anterior and superior portions of the uvula is a gland the duct of which is sometimes visible, and whose office is to keep moist the bucco-pharnygeal DISEASES OF THE VOICE. 159 region. (3) The uvula closes completely the pos- terior opening of the buccal cavity.* When inflammation sets in, the engorged portion is no longer under the control of the azygos mus- cle — a small muscle forming the substance of the uvula ; and relaxation and lengthening of the uvula take place, and a portion remains hanging down between the pillars. Besides the disagree- able sensation occasioned by the irritation j3ro- duced by the point of the uvula touching the base of the tongue, and which causes a continual desire to swallow, it interferes in a great measure with the production and modification of sounds. It may even, by the continued irritation produced, be the exciting cause of chronic sore throat or of laryngeal phthisis. The constant tremolo we hear in some voices, and which some singers with bad taste endeavor to cultivate, should rather be called tremor than tremolo, resembling as it does the voice of the * Professor Alfred H. Garrod, F.R.S., in a recent lecture, laid great stress upon the functions of the uvula, an organ present only in man and the anthropoid apes, and expressed his opinion that the uvula serves the purpose of preventing the food from entering the back part of the nose, if it should so happen that during the act of swallowing, the individual should make a sudden effort at expiratory breathing. The uvula, being pressed back by the moving food against the posterior wall of the pharynx, would so retain a free communication between the mouth and the pharynx, at the same time that the narea are closed by the soft palate. — St. Louis Ec. Med. Jour. 160 HYGIENE OF THE VOICE. agecl. In many cases I have traced this trembling to a relaxation and prolongation of the uvula ; the organ remaining hanging loosely is shaken by the air during the emission of the sound. The tremor always entirely disappeared when the parts were restored to their normal condition. The tonsils, two small ovoid bodies, are situated at the origin of both the respiratory and digestive tubes. They secrete a semi-transparent liquid, whose function is to lubricate the mucous mem- brane lining the pharyngeal region, so as to render it softer, and facilitate the movements of the parts during singing, speech, or deglutition. Though they do not in any way contribute to the produc- tion of sound, yet if we consider that the passage of air during inspiration tends to dry the vocal organs, their importance will be readily admitted. But they may be too voluminous, and in that case they will exercise a bad influence upon the quality of sound, or they may even interfere with its for- mation. Their enlargement gives rise to a partic- ular tone of voice, in the formation of which both the guttural and nasal timbres concur. Besides this, they impede deglutition, the respiration be- comes noisy and laborious, especially during sleep, and pressing against the opening of the Eustachian tube, which is behind them, consequently oppose the renewal of air in the internal ear, and thus DISEASES OF THE VOICE. 161 produce what is termed throat deafness ; a very grave thing for the singer, who needs so much to hear himself and others. Amongst the most marked effects of enlarged tonsils may be noted the derangement of health, and in young persons the arrest of development. Dr. Yearsley, who has observed the fact in numer- ous instances, says that it is probably to be ac- counted for : 1. By the enlargements exerting more or less pressure on the carotid artery, thus imposing an obstacle to the ready now of blood to the brain, by which the nervous energy of the body is dimin- ished and corporeal development is retarded. Any impediment to the due transmission of blood to the brain must exercise a prejudicial effect upon the nervous system. 2. By the food in its passage to the stomach be- coming imbued with the foul secretions poured out from these diseased glands ; for, if the food does not reach the stomach in a state of purity, that organ becomes disordered, and the general health suffers. From the lacunae of enlarged tonsils issue foul secretions, which taint the food in its passage down the throat to the stomach : the body there- fore must be deprived of its due supply of pure and wholesome nourishment. 3. By the air which the patient breathes becom- 162 HYGIENE OF THE VOICE. ing tainted on its passage to the lungs, and thus producing an effect identical with that of living in an impure atmosphere. The air which the sufferer from enlarged tonsils takes into the lungs in the act of breathing, is vitiated by having to pass over a diseased condition of the throat ; consequently it is tantamount to the patient living in an unwhole- some atmosphere, or an unhealthy and unsuitable climate. On the tonsils themselves the enlargements re- act in a very injurious manner. The large size and low organization of the glands renders them very liable to repeated attacks of acute or sub- acute inflammation. Patients with enlarged ton- sils are often so susceptible, that inflammation of those glands follows the slightest exposure, and comes on with the mildest catarrh. These fre- quent attacks of quinsy not only cause much suf- fering and augment the size of the tonsils, but when the already hypertrophied glands become still further enlarged by inflammation, there is often risk of suffocation. It may be well to bear in mind, also, that the danger of scarlatina, diph- theria, croup, and laryngismus stridulus, is, of course, greatly increased by any pharyngeal im- pediment to respiration. The extremely disagree- able intonation of voice caused by enlarged tonsils sometimes makes an effort to lessen the defect DISEASES OF THE VOICE. 163 very desirable. The voice is sometimes nasal in its tone, sometimes merely thick or muffled, more rarely guttural. This peculiarly unpleasant modi- fication in the voice is often so serious a drawback to young people, as to make them very anxious to overcome it. Snoring is another objectionable peculiarity, sometimes caused by enlarged tonsils. — (Morell Mackenzie, 1864, page 4.) " We can readily understand how a chronic en- largement of the tonsils, by interfering with the normal respiration, can lead to consumption. Only a portion of the requisite amount of air can be re- spired, and the development of the chest is thus interfered with. Indeed, we may even say that the capacity of the chest diminishes as the tonsils enlarge. Dupuytren was the first to notice that children whose tonsils were enlarged ended by having a deformed chest. In them the thorax was rounded behind, retracted in front, and flattened at the sides." * The aid of the physician or surgeon being often called in to remedy the injurious influence these organs,«small as they are, exert when diseased, not only upon the voice, but, as we have seen, upon the general health, I must express here my views concerning a method which, unfortunately, not- * The Author's Prize Essay on Consumption, 1870. 164 HYGIENE OF THE VOICE, withstanding its unsatisfactory, nay, its positively evil results, is yet too much practised. I allude to the excision or removal of the tonsils or uvula by the knife. This practice has strong advocates, I am aware, but I have the lessons of experience and the sup- port of good authorities. •" The experience of the most successful practi- tioners and my own, has convinced me that the partial or complete excision of the tonsils may cause an hemorrhage which it is sometimes diffi- cult to remedy ; fits of coughing, fainting, spasms, suffocation, are the accidents which accompany it. . . . As for the excision of the uvula, it is not without its difficulties ; we know that it can- not be seized without trouble, and without occa- sioning more or less intense pain. Finally, the ex- tirpation of the tonsils, and the cutting-off of the uvula, so ofteD practised upon singers and dra- matic artists, is never crowned with satisfactory results. In the most satisfactory cases, the part attacked by the scalpel becomes so very irritable that the least change in temperature, a forced declamation, and especially sustained singing or speaking, are sufficient to produce an angina which I have often seen extend to the pleura and lungs." — (Bennati, Etudes sur la Voix Humaine, p. 180.) DISEASES OF THE VOICE. 165 There is a case mentioned by Portal, in which a skilful surgeon, in scarifying the tonsils of his patient, wounded, as he supposed, some ramifica- tion of the internal carotid, and the patient was presently dead. — (Science and Art of Surgery, by John E. Erichsen, page 880.) Columbat, although doubting the statement of Wedel, that " the loss of the uvula causes the food and liquors to ascend the posterior orifices of the nasal fossae," admits that the operation may induce the nasal mucus to fall more readily in the throat, and also that the emission of acute notes may be rendered more difficult by the excision, which he condemns unless all other means have failed, or when the extraordinary tumefaction of the tonsils may endanger the patient's life. (Mal- adies des Organes Vocaux, page 134.) " It is, indeed, the fashion with many to snip off the tonsils and uvulas, with a view of curing a cough, which really is kept up by a source of irri- tation existing in the lungs." — (Da Costa, Med. Diagnosis.) Harvey states that the removal of the tonsils in- terferes with the development of the genital organs. An eminent physician, Dr. Ed. Fournie', says that " that operation (excision of the uvula), small as it is, may affect the general health." — (Etudes Pratiques sur le Laryngoscope, page 54.) 166 HYGIENE OF THE VOICE. Finally, we may sum up the above authorities, and say with Dr. Morell Mackenzie, of London, that the obstacles to the surgical extirpation of the tonsils are: (1) its dangers; (2) its difficul- ties ; (3) the objections to it entertained by many jDatients. There are, it is true, certain anatomic conditions which may necessitate the use of the scalpel. Tumefied or much ulcerated tonsils may require excision ; but when simply enlarged they may be brought back to their normal size by a few appli- cations of either the Vienna paste or the bichro- mate of potassa. It needs a little more time to reach the result, but it is much more certain and complete. CLERGYMAN'S SORE THROAT. From its name we might be led to regard this disease as peculiar to the class whose name it bears ; it is, however, by no means confined to the clergy, if I may judge from the large number of those of other professions who have sought my ad- vice. The symptoms of this trouble are : uneasy sen- sation in the upper part of the throat ; a continued inclination to swallow, as if there were some ob- stacle in the oesophagus which could be removed by deglutition. The sufferer also makes frequent DISEASES OF THE VOICE. 167 attempts to clear the throat of phlegm by cough- ing, hawking, and spitting.- Usually there is a change in the tone and quality of the voice ; cer- tain notes especially being altered, with more or less hoarseness towards evening. This is sometimes entirely a nervous affection. Among its other and more common causes may be mentioned a natural weakness of the vocal organs ; indigestion; exposure to cold after using the voice ; an improper position of the head or chest, as in bending over a desk or reading-table ; in fact, anything that interferes with the full play of the lungs. I append here the forcible remarks of Dr. Fen- wick, which illustrate fully my meaning : " Clergyman's sore throat is due entirely to a neglect of observation of the mechanism of speak- ing. If the perfectly erect position of the spine is of so much importance for easy breathing, can it excite surprise that so many cases of throat disease present themselves among public speakers, when the habit of stooping is so prevalent, both on the platform and in the pulpit. Nothing is more common than to see a clergy- man bending forward over his sermon, with his chest contracted, and his throat bent ; or to ob- serve an orator, at a public meeting, with his hand 168 HYGIENE OF THE VOICE. concealed in waistcoat pocket, and the motions of his chest consequently limited." To the causes already given may be added sing- ing or speaking while suffering from a cold. The exertion causes an increase of the inflammation already existing ; 23erversion of the secretion of the glands lubricating the vocal cords ; then fol- lows thickening of the tissues, and permanent mis- chief ensues. But too often has the attempt to " work off " a slight hoarseness succeeded in ruin- ing forever a fine voice. We all know that a certain preparation or train- ing is absolutely necessary for the accomplishment of any feat requiring the continued use of any one set of muscles, and that absolute rest following such training lessens very rapidly the power of the trained muscles. The very brain itself, if not reg- ularly worked, loses power. Now this is exactly the condition of the clergy. Many of them ex- haust the whole physical frame by the exertion of the vocal organs on the Sabbath day, and allow them absolute rest for the succeeding six. Is it any wonce.' that the overtaxed organs finally re- pay in kind the abuse they have suffered ? Continued speaking in one tone of voice is also a cause of this trouble. The muscles are far more strained and fatigued than if there were an alter- ation in the pitch of the voice. " Whenever," says DISEASES OF THE VOICE. 169 Fenwick, " we liear a clergyman droning through the church service, and, in the same manner and tone of voice, reading, praying, and exhorting, we may be perfectly sure that he is giving ten times more labor to his vocal cords than is absolutely necessary." We have thus seen how many causes may pro- duce this peculiar sore throat, and therefore the management of each case must depend on the opin- ion the physician forms of it. In its earlier stages, if it is of nervous origin, tonics, especially iron and quinine, cold shower-baths or sea-bathing, and, if possible, temporary change of scene and occupa- tion, are the remedies. If due to the habit of stooping, correct this by the constant assumption of an erect position. As moderate exercise, grad- ually increased, is as beneficial to the voice as to the limbs, the clergyman should read aloud once or twice daily, using the same pitch and volume of voice as liis professional duties demand. If, however, the disease is far advanced, and the throat and fauces present an unhealthy, slightly raw and granular appearance, with not only in- crease in the quantity of the secretions, but change in their character, so that they have become an acrid, viscid discharge, firmly adherent to the membrane, and a source of irritation, medical ad- vice should be sought at once. 170 HYGIENE OE THE VOICE. LARYNGITIS. Acute laryngitis or acute inflammation of the mucous membrane of the larynx, is a malady of frequent occurrence, caused usually by cold, damp- ness, and the harsh atmospheric variations of changing seasons. Laryngitis is sometimes pro- duced by violent or protracted efforts of the voice in speaking or singing. When the trouble is but slight, it is restricted to a simple .hoarseness. The voice has not its usual purity and strength, and any attempt to clear the throat by coughing is unavailing. After a few days, sometimes a few hours, the hoarseness disappears without the aid of medicines. In pronounced inflammation of the larynx, the voice presents marked alterations. It is hoarse, rough, broken, and utters sounds alternately harsh and screeching ; speech is difficult and painful, especially when it becomes necessary to speak loudly. Without being accompanied by fever, it, howe ver, induces a feeling of prostration, ' dimin- ishes the appetite somewhat, and requires a certain amount of nursing. Of intense laryngitis giving rise to suffocating symptoms, or of tracheitis (inflammation of the wind-pipe), this is not the proper place to speak. . DISEASES OF THE VOICE. 171 BRONCHITIS. Inflammation affecting the mucous membrane of the bronchial tnbes is called bronchitis. Of all diseases of the throat it is, perhaps, the most com- mon. "When the body is exposed to the cold of a low and even temperature, it reacts with force, produc- ing heat enough to maintain its normal condition. In such a case no cold can be taken, for a cold is not the effect of exposure to cold air, but from " cool- ing off." Habitual exposure to cold air, when not followed by a cooling-off, is not injurious to the health, but beneficial, for it increases the strength. Bronchitis is due to the combined effects of the cold air inhaled, and its action also externally, under peculiar circumstances : as in the fall and spring, when the variations of tenxperature are sudden ; and in foggy and damp weather. Damp- ness itself is a consequence of a variation in the temperature. A hot and dry air becomes damp as soon as it cools ; for, however dry it may appear to be, it contains, nevertheless, a certain quantity of vapor of water, which the least cold condenses into a fog. The high winds of the fall and spring are also active causes of cold, because the air re- spired is renewed . too frequently, thus producing a cooling-off of the bronchial tubes. 172 HYGIENE OF THE VOICE, Winter bronchitis arises from the fact that our habitations are kej)t so very warm that we cool-ofE or chill the moment that we leave the house. The same cause explains the numerous colds caught on leaving ball-rooms, theatres or churches, namely, the passing suddenly from a very high temperature to a very low one. " But,' 1 some one may say, " I take cold also in summer." Yes, but if you look back you will recall that, being much heated, you either stood or sat still in the shade, took a cold bath, or drank freely of ice-water. Among the causes of bronchitis we may men- tion the putting on the summer clothing too soon, or delaying too long to assume the winter dress, or remaining too long inactive when the clothing was wet with rain or perspiration. The principal symptom of bronchitis is cough. First dry, then after twelve or twenty-four hours expectoration begins, of stringy and salty serosity. This soon gives place to small, shining, and gray- ish spit, somewhat hard to bring up. Then the cough becomes easier and less frequent. It is loose, the expectoration changes its character and becomes large, thick, opaque, whitish, greenish, or yellowish ; the cough ceases and the cold is better. DISEASES OF THE VOICE. 173 Nervous or essential asthma is dependent upon a weakness of the bronchial tubes, during the ex- istence of which state even slight causes produce paralysis. In some cases this condition is constitutional, or even hereditary, while, in other cases, it follows as the sequela of some disease, such as scarlatina, whooping-cough, pneumonia, or typhoid fever, in which the lung has been affected ; or it may be caused by a strong moral emotion, by fright, by anger, or by deep sorrow, which has acted strongly upon the nervous system, and lessened the amount of nervous force distributed to the contractile fibres of the lung. In this weakened condition of the bronchial tubes the most trivial causes are sufficient to pro- duce an attack of asthma. Among these causes the first is sleep, especially if it is deep, as it usu- ally is between 10 p.m. and 2 a.m. This singular fact is easily explained when we remember that sleep is -only an incomplete j)aralysis of the intel- lect, and in a less degree of the heart and lungs — for we always find the rate of respiration and the force of the heart's action lessened. If, then, the sleep be prolonged, the paralysis it determines may 174 HYGIENE OE THE VOICE. extend to the muscular fibres of the bronchi, and produce asthma. Many asthmatics suffer whenever they sleep in darkness, or when during their slumber certain noises, such as the rolling of carriages, the ticking of a clock, the murmuring of a stream, etc., to which they have been accustomed, are absent. The probable explanation is that if light and noise pre- vent asthma, they do so by rendering the sleep less profound, and thus the lung is affected less deeply. At other times the fit of asthma is brought on by breathing an atmosphere either too dry or too moist, too cold or too warm, too dense or too rare- fied, too calm or too agitated. Some sufferers are so sensitive to atmospheric changes that they indicate these changes more quickly and more surely than a barometer, and, like the birds, announce the com- ing rain and storm. A curious fact is the effect which certain pow- ders or odors have in determining an immediate attack of asthma, while other substances, which would seem far more likely to be harmful, have not the slightest effect. Among other causes provoking an attack of asthma, we may mention : errors of diet, the abuse of alcoholic liquors, and violent exercises. Nervous asthma may be described as a fit of suf- DISEASES OF THE VOICE. 175 focation coming on suddenly while apparently in perfect health, and disappearing as suddenly with- out leaving any traces behind. Often the attack occurs without warning, in the middle of the night, the sufferer having retired full of gayety and health. At other times the premonitory symp- toms are well marked. For a few hours, or even for a day, the asthmatic feels dull and tired ; he yawns and stretches himself ; the stomach and ab- domen are distended by gas, and painful upon pressure ; the urine is abundant and clear as water. Whether it is announced or not, the attack usually comes on during the night, when the patient is en- joying his deepest sleep. Suddenly, without ap- parent cause, the asthmatic awakes to find him- self struggling for breath. He sits up in bed, or more often hastens to the window, throws it open, and eagerly breathes the external air, even in the midst of winter. This sometimes cuts short the attack, and after a few minutes he returns to bed to pass a comfortable night. But oftener the at- tack continues, and the difficulty of breathing, far from diminishing, steadily increases, and the harsh, rapid, and broken respiration is accompanied by a whistling which is heard at some distance. Seated on his bed or astride a chair, or holding fast to the window-sill, with nares and mouth wide open, and head thrown back, the sick one vainly exerts all 176 HYGIENE OF THE VOICE. his muscular power to dilate the chest and force air into the lungs through the nearly impermeable bronchial tubes; in vain, for the air apparently stops in the throat and cannot pass lower. Use- less the endeavors of the asthmatic to free his chest by coughing ; the cough remains dry, and, in- stead of diminishing, the suffocation increases it; the asphyxia makes progress after each paroxysm ; the sufferer feels that air is refused him, that he will die, and the fear of suffocation increases his agony still more. After such an attack has lasted several hours, it begins to abate, usually with the dawn of day. The respiration is longer and easier, the speech less brief and broken, the cough less harassing and more moist, the mucus which had obstructed the bronchial tubes is detached, and then follows great relief. The sputa varies much in aspect and consistency : sometimes it is a colorless, viscous liquid, similar to gum-water; at others, it is thick and opaque, and of a grayish, yellowish, or greenish color. In a small number of cases the expectorated matters have a firmer consistency, are of cylindrical shape, similar to cooked vermicelli, and reproduce exactly the form of the bronchial tubes in which they were moulded. As soon as the bronchi are freed from the mu- DISEASES * OF THE VOICE. 177 cus which filled them, the oppression, the cough, and the feeling of suffocation disappear as if by magic. The asthmatic feels tired by the violent efforts he has made, his chest and sides are sore, and he craves one thing — rest. He returns to bed, sleeps peacefully, and on awaking feels nothing of his attack but a slight soreness, and is free for some time from his malady. Unfortunately, however, all attacks do not end so soon ; sometimes the feeling of oppression con- tinues, in the evening the abdomen swells, and there is a repetition of the attack, as bad or worse than the preceding one. This may be followed by a third or even a fourth. It may disappear for a while, but usually remains to reproduce itself dur- ing the whole life, unless remedied by proper med- ical care. APPENDIX APPENDIX. Gargling is commonly resorted to in most of the affections of the throat, yet most people have but little conception of its rationale or method of use. Gargling may be accomplished in one of three ways : 1st. The most common and least effective is performed by the following disposition of the parts : the base of the tongue having been raised, the muscles of the soft palate are then relaxed in order that the latter may come in contact with the base of the tongue, while the uvula is laid point forward in the groove formed in the surface of the tongue. Thus all communication between the cavities of the mouth and pharynx is cut off, and expiration takes place through the nose. If the parts are arranged as above directed, breathing through the mouth can only be accomplished by the exertion of sufficient effort to overcome the resistance offered by the contact of the mucous 182 HYGIENE OF THE VOICE. membranes, and this effort, on account of the posi- tion of the uvula, is greater in inspiration than in expiration. In expiration the soft palate is lifted by the current of air, in inspiration there is a ten- dency to force it into still closer contact with the tongue. The passage of the expired air causes a fluttering motion of the uvula, and the guttural r-r-r-r is produced. This form of gargling, then, only brings the fluid in contact with the walls of the buccal cavity. In this method : 1st. The head is thrown backward to retain the fluid. 2d. The fluid does not go beyond the buccal cavity, or, if it does, is instantly swallowed. 3d. Swallowing is unavoidable, and is caused by the opening of the glottis to give passage to the air breathed through the nose. 4th. Breathing continues during the gargling, being carried on through the nasal cavity. The second method of gargling is accomplished by throwing the head far backward, in order to dilate the pharynx. The fluid readily finds its way in the pharyngeal cavity, but the position of the head gives rise to incessant and irresistible at- tempts at swallowing, which, while they prevent the fluid from penetrating the larynx, cause, in spite of all efforts, part of it to enter the stomach. The third method is a combination of the pre- APPENDIX. 183 ceding ones, and by it a fluid may readily be in- troduced into the mouth, pharynx, the sub-glottic portion of the larynx, and even the nasal cavity, without a drop being swallowed. For its accom- plishment the following rules must be observed : 1st. Raise the head slightly. 2d. Open the mouth moderately. 3d. Bring the lower jaw forward by raising the chin. 4th. Place the vocal pipe in the position to emit, or rather actually produce the sound of e in in the word Tier. 5th. Breathe easily and regularly. If the different motions given above be per- fectly carried out, the pharynx will be widely dilated, the soft palate and uvula will be raised, and the base of the tongue drawn forwards from the posterior wall of the pharynx, and thus the fluid will be carried by its own weight alone into the cavity of the larynx. In practising the laryngeal gargling, the following must be strictly observed in breathing : as long as the fluid re- mains in the larynx the breath must be held, al- lowing only a slow, well-regulated expiration, in order to avoid the necessity of a sudden and invol- untary inspiration ; any attempt at ins juration while the gargle is contained in the larynx would carry the fluid with the air through the half-open 184 HYGIENE OF THE VOICE. glottis, and there would follow the convulsive coughing and sensation of strangling, which is ex- jjerienced when something "has gone the wrong way." Each mouthful of gargle should only be retained the space of time required by a prolonged expiration, and previous to taking a mouthful the lungs should be well filled with air. This method of gargling can be acquired readily by very little practice ; the less the head is raised, the less will be the inclination to swallow, and thus the desire to do so can be overcome entirely ; while if the head be thrown far back, the inclina- tion to swallow will be irresistible. With practice one can force the fluid through the nostrils, just as a smoker forces the smoke of a cigarette, thus bathing in the most perfect manner the diseased surface of the entire mucous mem- brane. PRESCRIPTIONS. Any of the following prescriptions copied out and sent to a chemist would be made up without difficulty. 1. — Cold in the Head. Hoffman's anodyne six drachms. Paregoric five " Tincture of tolu five " Mix. Put one teaspoonful into a pint of boiling water. Cover the head and basin with a towel or cloth, and inhale for from three to five minutes. 2. — Coryza. Opium one and a half grains. Pure water half an ounce. Mix. To be snuffed up. 3.— Wash for Sore Mouth. Borax half an ounce. Tincture of myrrh one ounce. Pure water ten ounces. Mix. 186 HYGIENE OE THE VOICE. 4. — Stimulating Liniment in Common Sore Throat. Soap liniment, Opodeldoc of each half an ounce. Tincture of arnica one drachm. Mix. "Wet a piece of flannel with the liniment and apply to the throat. 5. — Astringent Gargle in Relaxation of the Throat and Uvula. Alum three drachms to half an ounce. Barley water ten ounces. Syrup of poppies or honey one ounce. Mix. 6. — In the Same. Tannin one drachm. Honey three ounces. Pure water four ounces. Mix. 7. — In the Same. Glycerine of tannic acid ten drachms. Water to half a pint. Mix. To be used three or four times a day. 8. — Gargle in Chronic Inflammation of the Throat and Clergyman's Sore Throat. Carbolic acid twenty minims. Compound spirits of lavender half an ounce. Tincture of myrrh half an ounce. Syrup of tolu one ounce. Pure water six ounces. Mix. PRESCRIPTIONS. 187 9. — Opiate Gargle. Laudanum three drachms. Tincture of belladonna two ounces. Camphor mixture six ounces. Mix. Use frequently. 10. — Tonic Gargle Alum two drachms. Claret wine six ounces. Decoction of Peruvian bark six ounces. Honey one ounce. Mix. 11. — Tonic Gargle in Relaxation. Tincture of myrrh one ounce. Alum one drachm. Pure water seven ounces. Mix. 12. — Gargle in Chronic Hoarseness of Growing Boys. Tincture of red pepper one drachm. Decoction of Peruvian bark six ounces. Mix. 13. — Cayenne Pepper Gargle. Tincture of capsicum one hundred minims. Dilute acetic acid fifty minims. Water to half a pint. Mix. To be used two or three times a day. 188 HYGIENE OF THE VOICE. 14. — Cough. Paregoric one ounce. Tincture of belladonna one ounce. Tincture of hyoscyamus. two drachms. Compound spirits of lavender one drachm. Mix. Ten drops on a lump of sugar every hour until the cough is relieved. lb.— Cough Mixture. Bromide of potassium, Chloride of ammonium, Chlorate of potash . . of each one and a half drachms. Syrup of squills, Syrup of tolu of each two ounces. Mix well. One teaspoonful every third hour. 16. — In Chronic Bronchitis with Excessive Secretion. Spirits of turpentine one ounce. Warm water four ounces. Mix and inhale the vapor. BIBLIOGRAPHIC LIST OF WORKS REFERRED TO. Beaumont (William). The Physiology of Digestion. Phila., 1847. Beauquier (Charles). Philosophie de la musique. Paris, 1866. Bennati. Mecanisme de la voix humaine pendant le chant. Paris, 1832. Brouc. Hygiene philosophique des artistes dramatiques. Paris, 1836. Colombat (de l'lsere). Traite des maladies de la voix. 1838. Cuvier. Lecons d'anatomie comparee. V. 4. Paris, 1805. D ALTON (J. C.) Human Physiology. Phila. , 1872. Debay (A.) Hygiene et gymnastiqiie des organes de la voix. 1861. Desplney (Felix). Recherches sur la voix. These, Paris, 1821. Draper (John W. ) Human Physiology. New York, 1858. Dutrochet. Essai sur une nouvelle theorie de la voix. These, Paris, 1806. Fourni£ (Ed.) Physiologie de la voix et de la parole. Paris, 1866. Harvey (William). On Enlarged Tonsils in Deafness. London, 1864. Longet (F. A.) Traite de physiologie. Paris, 1860. Malgaigne. Memoires sur la voix. Archiv. gen. demedecine. 1831. Mandl (L.) Maladies du larynx et du pharynx. Paris, 1872. Mackenzie (Morell). The Use of the Laryngoscope in Diseases of the Throat. 1864. Muller. Manuel de physiologie. 1851. Rush (James). The Philosophy of the Human Voice. Phila., 1867. Segond (L. A.) Hygiene du chanteur. Paris, 1846. Stephen de la Madeleine. Theories completes du chant. Paris, 1864. Yearsley (James). On Throat Deafness. London, 1864. iSTSSLffi CONGRESS o msm