The Voice: Its Production, Care and Preservation

by Frank E. Miller

In the case of one of New York's most experienced singers, it required two years of persistent effort on the part of both patient and physician to overcome the habits of a lifetime. The case is of general importance for the reason that the habits he had formed are more or less common to all of us, though perhaps not to such an aggravated degree. He was an inveterate smoker and a confirmed coffee drinker. These habits reflected themselves upon the poor, defenceless mucous membrane,

whose function was perverted as shown in the constantly congested appearance of the respiratory tract. I have seen this artist with congested vocal cords rehearse an oratorio in the afternoon at a public rehearsal and sing the same work in the evening at the regular concert performance, when, to use his own words, "I feel as if every note will be my last. I have no grip on my voice." It was a clear case of indomitable will and sheer physical strength carrying the singer over obstacles that even to my mind seemed well-nigh insurmountable. A cure was effected in this obstinate case simply by insisting upon observance of hygienic law. There is no better instance of efficacy of vocal hygiene than in the case of this man. The gradual reassertion of nature, as indicated by the clearing up of the inflamed mucous membrane of the nose, the thickened condition of the pharynx and the chronically congested cords, was an all-sufficient reward for anxious thought spent upon an important subject. You may ask what was the remedy in this case. It was simply advice given and heeded, together with needed incidental treatment. I cut off his coffee and cigars, not immediately but gradually. He had sufficient force of character to aid me by heeding the counsel. The result was a diminution of

secretion of the mucous membrane and a return to normal conditions.

Right here there is another phase of the situation to which I desire to call particular attention, not alone because of its vital importance to the singer, but also because of the danger to the unschooled student of neglect of what we ordinarily term a cold in the head in its first stages. By the first stage of the cold I mean that condition which obtains before the stage of secretion is arrived at, where the mucous membrane is being congested, where it is almost impossible to distinguish what is the highest point of normal stimulation under which the membrane may be expected to do its best work. This point may be aptly illustrated by comparison with a singer under perfectly normal conditions. Then, as is well known, it is the mental impulse that stimulates nerve, muscle and membrane to do their best work. But in the other condition this result is attained without the mental impulse, as we have the mucous membrane and the blood-vessels carried to a temporary climax of effectiveness due to the systemic disturbance. By this I wish to make clear my point, that artists have often noticed an unusual brilliancy of voice under circumstances which were all the more mysterious because of the sudden collapse

of the vocal organ under stress of use, and the alarming suddenness of the catastrophe which overtakes them and leaves them totally incapacitated. Then they say, "I have a cold;" whereas it requires from twenty-four to thirty-six hours for the fulfilment of these conditions. They should have reached this sensible conclusion just two days before. I take issue with those physicians who urge that certain exercises should be given to the artist when the vocal cords are in a state of congestion, for the reason that it requires a period of from ten to fourteen days for the complete relief of this inflammation. During that period, the blood-vessels are fully employed absorbing the products of the inflammation, and any attempt to interfere with this necessary process of nature can end only in disaster or in a prolongation of the difficulty. This is the law of pathology, unalterable and not to be evaded. Physicians at times resort to soothing and astringent applications in an emergency, to carry the artist through a performance; but the lack of edge to the voice for weeks following is an all-sufficient indication of the revenge nature takes for this trespass upon her domain.

The cause of the sudden disaster to the voice which I have described is not far to seek. The cold has

caused over-stimulation of the mucous membrane of the larynx, and a consequent loss of voice. This cold begins in the head, and on the third day, perhaps before, it has attacked the larynx. Why? Because the mucous membrane has become so swollen that the nasal passages are obstructed and the mucous membrane of the larynx has to perform a double function, that of heating the air as it is brought to the lungs in the process of respiration, as well as carrying out its own obligation to the scheme of nature. By a strange coincidence, this membrane of the larynx is supplied with sensation by the same nerve that conveys motion to one of its tensor muscles. This is the superior laryngeal nerve. By the thickening of the mucous membrane, all the intrinsic muscles of the larynx are interfered with, and, consequently, total extinction of the voice follows swiftly upon excessive inflammation. There you have it in a nutshell. The mucous membrane of the larynx and the bronchial tubes, to enlarge upon its duty for a moment, is endowed with very fine, hair-like processes called cilia, whose action is to waft secretions from the interior of the lungs outward. Hence the danger of promiscuous spraying with all sorts of everyday nostrums, or of anything which may interfere with the activity of these

minute bodies or the media in which they operate.

This intimate relation of nerve and muscle and mucous membrane is best illustrated by the sneeze. The explanation of this is an over-stimulation of a part of the mucous membrane of the nose called the Schneiderian membrane. If we analyze the sneeze, we find that it simply consists of a spasm of the pharynx, larynx and diaphragm through the reflex action of this membrane. The over-stimulation of the membrane, in the case of the singer especially, may generally be set down to an incipient cold; but any inflammation of this part of the mucous membrane of the nose alone may give rise in reflex action to vocal disability.

There are some peculiarly interesting isolated instances of disturbance of the vocal mechanism, which are unique in that, while apparently harmless and uninteresting from the standpoint of even the specialist, they have, on occasions, developed most alarming influence over the voice. They have no precedent; experience alone can determine their influence for evil. They are not a matter of record, they are simply études, interesting studies in the bypaths of vocal hygiene, and must be dealt with as they appear. An exceptional example was one wherein