The Voice: Its Production, Care and Preservation

by Frank E. Miller

While this is a truism, yet it cannot be too strongly emphasized nor too often reiterated; for with all their notable precautions, singers are often taken unawares and fall when most they desire to stand. Why? They are simply paying the penalty of a broken law, and it does not help them with a disappointed club committee, or in framing a telegram of regret, accompanied by a physician's certificate,

to say that they have erred through ignorance. The aphorism that ignorance of the law is no excuse is just as valid in the court of the hygienic judge as in any common law court between the oceans.

It is the prevalent practice to use the physician as the court of last resort. But it would be vastly better and far more sensible if the singer could be made to act with swift authority as an agent of prevention over the weaknesses of his or her own nature. The subject, thereby, would be vastly simplified. It would not be so profitable to the specialist; but I can vouch for it that he would not only forgive, but praise the discretion of his patient, and lend all possible aid to educate him along a new scientific path—that of prevention. Not a new path, either, for in its last analysis what is hygiene but the science of prevention? Preservation of health means the prevention of disease. This answers the cry of every artist's heart, especially that of the vocal artist, teacher and student: How can I prevent disease and weakness of the vocal machinery? Briefly and plainly: How can I keep well?

In this important matter of vocal hygiene a prominent part is played by the mucous membrane. What

is the mucous membrane? It is the membrane which in this special sense covers or lines the respiratory tract from the very outlet of the nose to the terminal bronchi; in fact, to the very air-cells of the lungs themselves. Its function is that of supplying the involved passages with moisture, and it secretes a glairy or watery substance called mucus. Now, mark this well. The entire area of the respiratory tract, from the nose to the bifurcation of the bronchi, it is said on good authority equals one square foot of exposed surface, and the amount of secretion per day equals about sixteen fluid ounces, or a pint, which must be secreted by a person in the normal condition of health. It also has the power of absorption of certain diverse substances, such as alkaloids, fluids of all kinds, hence the danger of alcoholic indulgence to the singer. Alcohol coagulates. It causes the epithelium to contract and to become so disintegrated as to be utterly incapable of performing its functions until such time as the underlying tissue shall have created new cells to take the place of those which have been destroyed. To illustrate briefly the varied functions of this membrane: Whereas alcoholic stimulant destroys it, another powerful drug, cocaine, is absorbed, often to such an extent that the patient

is prostrated by the poison introduced into the system by this means, and yet without impairing the membrane to any extent except through persistent indulgence.

The mucous membrane is the telltale of conditions. If a man's tongue is coated with detritus—which, anglicized, is nothing more than the products of decomposition, a coating formed by over-stimulation of the glands lying at the base of the tongue—and this has been previously superinduced by a disordered stomach, we know that the cause is indigestion. If the follicles in the back part of the pharynx or throat appear distended, and even the tonsils themselves are affected—and these again are part and parcel of this same mucous membrane—we can say this is due to one of several causes: either to a reflex condition from the stomach, due to over-eating or over-indulgence of some other equally deleterious sort, or to inactivity of the bowels, or to suppressed perspiration, or to improper or undue use of the vocal organs.

Again, let us glance for a moment at what a good many people deem a superfluous appendage, the uvula. A patient comes into my office with a badly swollen uvula. The upper tones of the voice are gone. He has no complicating quinsy, and in that

case I can say without hesitation that he has outrageously misused his voice. I ask him where he was the previous afternoon, and find he was jubilantly "rooting" for the New York Giants in an exciting baseball contest. Now, it in nowise lessens the force of my illustration that this patient was not a singer and did not acquire, if you please, his swollen uvula in orthodox fashion. It is only a short time ago that a man came to me with a pronounced case of œdematous uvula, or swollen soft palate. He announced to me that he was no longer a tenor singer, although he had sung tenor for three years; that lately he had been persuaded that his voice was baritone; and, indeed, he had been singing, up to the time of coming to me, a baritone part in opera. It was this which brought him under my hand as a patient. He had changed his teacher, who had insisted that he was a tenor, within two months, and since that time had been under the instruction of the master who had declared that he was a baritone. I had known him for some time, and the only perceptible change to me in the voice was a decided tendency to cover and sombre the upper tones. Upon examination, the only thing abnormal was the condition of the soft palate and the surrounding tissue extending down both pharyngeal pillars.

The soft palate was swollen to nearly three times its original size and hung down upon the tongue. The symptoms he complained of were inability to sing above F, and all high tones were husky. The production of the upper tones was accompanied with considerable pain. An emollient gargle was given and, soon after, astringent applications; but in vain. It was necessary three weeks afterward to amputate the uvula. Within three weeks more the operation was demonstrated a success in that the upper tones were fully restored; but I leave the question with the teachers whether this operation would have been necessary had not this young tenor been drawn aside on the purely theoretical issue as to whether he was not a baritone instead.