Music Trade Review
Issue: 1881 Vol. 4 N. 9 - Page 3
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THE
mptf Critic &
mm
With which is incorporated THE MUSIC TRADE JOURNAL.
NEW YORK, JUNE 5TH, 1881.
VOL. IY.
THE THROAT IN ITS RELATIONS TO SINGING.
A SERIES OF POPULAR PAPERS BY WHITFIELD WARD, A.M., M.D.,
TO THE METROPOLITAN THROAT HOSPITAL.
PHYSICIAN
XL
SOME OF THE MORE COMMON THROAT AFFECTIONS OF SINGERS, TOGETHER WITH
THEIR TREATMENT.
The following query is often put to me, why are singers more liable
than any other class of individuals to throat troubles? Simply because they
are continually using this portion of the human organism, which makes
it more susceptible to outside influence on account of the greater amount of
blood being attracted the parts.
In affections of the throat, the mouth may be only involved and the
larynx free from disease, or the larynx may be attacked the mouth escaping,
or what most generally happens, both the mouth and the larynx may be
attacked together. I will pass over the many diseases of the mouth as they
will be of little interest to the non-medical mind and allude to some of the
more interesting of laryngeal affections, which are commonly met with in
singers. The most common disorder in the laryngeal tube is an ordinary
simple inflammation, or as it is popularly termed a " cold." There are many
ways of taking cold in this the most changeable of all climates. Among
the prominent of which are, an untimely changing from a heavy to a lighter
texture of clothing or vice versa; sitting in draughts; the wetting of the
body, especially the feet; sleeping at night under open windows with an
insufficient amount of covering, &c., &c. A special cause with reference to
vocalists is, the passage from a warm apartment to the street, particularly in
cold weather, immediately after singing. The cold is contracted because
the vocal organs are temporarily congested—a natural consequence of sing-
ing—which renders the organ particularly liable to atmospheric action.
This subject has been fully discussed in the article entitled " t h e care of
the voice," and need not be again entered upon here. The most prominent
symptom of a common cold is hoarseness. The voice is hoarse in direct
proportion to the amount of inflammation. In some intense cases the voice
is utterly gone, the person so affected being unable to speak above a whisper.
The other symptoms, which will be instantly recognized by those who have
thus suffered, are a tickling of the throat and a greater or less amount of
cough according to the severity of the inflammation. In the treatment of a
common cold most any person will be able to give you one if not more reme-
dies that will, according to the ideas of the donator, assuredly effect a cure.
I n some instances when the nature of the affection is mild, simply confining
one's self to the house and enclosing the neck in poultices, or what not, as
we all know by personal experience, will be all that is necessary to effect a
cure in the majority of instances after the lapse of a varying amount of time,
say from a week to ten days. But in cases of professional vocalists, who
cannot afford to lay by for so long a period, other treatment than that just
alluded to is demanded. There is another and a great reason why singers
should have the proper treatment, and that is that a certain per cent, of
these cases of ordinary colds do not recover in themselves, but pass on to a
chronic inflammation of the larynx, a most persistent and troublesome affec-
tion, and one necessitating a regular course of treatment.
Therefore, although the non-professional may tamper with their throats
and trust to nature to affect a cure, the singer, whose livelihood depends
upon his voice, dare not run the risk, since the beginning of the breaking
down of many voices can be traced to some such effect as the above. There
is only one way in which inflammation, when it has taken hold of the inside
of the larnyx can be combated, namely: by the introduction of medicines
directly into the tube by means of little camels' hair brushes or sprays. In
this way the affected parts are touched and the disease conquered. To those
who have carefully read my foregoing papers, it will be superfluous to state
that medicines cannot be applied to the interior of the voice-box except by
means of the little mirror of the laryngoscope, since the parts are out of the
direct line of vision, or, to use literal language "around the corner." In
order to perform this little feat, the larynx must be displayed on the little
mouth-mirror, and the brush entered into the interior of the organ by means
of the image thereof. I would respectfully beg to say a few words to the
musical profession respecting the application of remedies to the larynx in
the way I have just described. Singers have a popular dread of being thus
treated, and this feeling is fostered by many teachers or voice-trainers
who instruct their pupils "never to let any one poke a brush down their
throats." This advice is absurdity and folly in the highest degree, and
can only be engendered by a total ignorance of the subject. If the
brush is properly used, and the right medicine is applied, I will
defy anybody to say that the voice can be thus harmed. If it were
so there would be no virtue in medicine, neither would there be any
use of spending years in studying up and perfecting one's self in this the
most interesting of the medical sciences. I will not deny that if the brush
is used by a person unskilled in treating the larynx or the remedies adminis-
tered be too strong or of a wrong nature, that harm might result to the suf-
ferer, but this is not the fault of the regular specialist, but rather of the
seeker after advice, who should see to it that they are in the right hands.
The dread which some singers have of the introduction of a brush into the
larynx is sometimes exceedingly laughable, and only equaled by the surprise
exhibited by the same individuals, when they ascertain by practical experi-
No. 9
ence, how simple the thing is when it is done properly. The sensations
experienced by the patient during the passage of the brush into the larynx
are of the most trifling nature, there being not the slightest pain caused by
the skillful operator.
There is one point on which I must strenuously advise the sufferer
with a cold, and that is not to sing while hoarseness exists. That soma
teachers make their pupils sing while the voice is in this condition, is a well-
known fact. Why they do this I am unable to state, except it is their
love of gain. Many of the chronic affections which are so frequently found
in the throat, are no doubt caused by such acts of in judiciousness as this.
In conclusion I cannot lay too much stress upon the importance of singers
attending to the affection above described, as a few applications at the right
time might save a tedious course of treatment, extending perhaps over sev-
eral months. A chronic inflammation of the larynx, or as it is technically
called, chronic laryngitis, is an exceedingly troublesome affection. It is also
often very insidious in its development, generally occupying from two to six
months. Its prime cause is a neglected cold or a series of neglected colds.
The vocalist afflicted with this disease gradually notices that the voice is not
the same as it used to be; that the high notes are difficult te take and some-
what blurred; that a much greater effort is required to produce tones that
could hitherto be sounded with extreme ease; that the richness of the voice
is considerably diminished; and that execution is more labored. In fact to
speak in a general way, the voice is giving out. If the above symptoms are
accompanied with a slight hacking cough and a persistent tickling of the
throat, together with a dryness of the parts, and the expectoration of a frothy
matter, the person so affected may rest assured that he has this disease.
Unless the affection is arrested by the proper course of treatment, the signs
above enumerated are bound to become intensified, which will sooner or later
altogether destroy the singing voice. In ordinary cases the talking voice is
not so much affected, but in some severe types of the disease, it is markedly
influenced and sometimes altogether gone. A most common cause among
singers for this variety of laryngeal disease is a strained voice. When pro-
perly used the vocal cords can perform a remarkable amount of work, but
when abused these delicate bands will soon show the effects of the maltreat-
ment by failing to respond when called upon. The most common effect of a
strain of the voice is a giving way, or a relaxation of the cords. Naturally
the two vocal cords when they are. brought toge-
ther present a very firm appearance. Now if these
bodies are relaxed, they will be seen to be very
flabby when they are abducted or approximated.
This manifestation will be instantly understood by
gazing for a moment on the subjoined pictui'e and
comparing it with the natural firmness of the vocal
cords as shown in Fig. 10.
Another prominent effect produced by the same
Cords.
^f
order that the cords shall vibrate properly—an
element which, as already shown, is absolutely necessary to vocalization—
they must be very thin, consequently if they be abnormally thick a proper
vibration of them will be out of the question, hence the voice will be seri-
ously impaired. As has been already stated with reference to the treatment
of ordinary colds, chronic laryngitis can only be cured by the direct appli-
cations of medicines to the diseased organs through the agency of brushes
or sprays. A paralysis of one or more of the vocal muscles is quite fre-
quently seen as a direct result of an abuse of the voice. Any of the vocal
muscles may be thus affected, the principal ones involved, however, being
the set known as the adductors or approximators of the vocal cords. A most
interesting case of this variety of throat affection occurred to me in my prac-
tice a little less than a year ago. The case referred to was that of a delicate
young lady, aged about 18, a pupil of one of the conservatories in this city.
Upon questioning her I ascertained that although her voice had been good
up to within three or four weeks, at the time of her examination it was impos-
sible for her to utter any musical sound except with the greatest effort. Acts of
talking also produced a considerable amount of pain. Upon a laryngoscopic
examination I readily discerned the cause of all her difficulty, namely: an
imperfect adduction or approximation of the vocal cords due to a paralysis
of one of the adductor muscles. The case was of such interest that I had a
drawing made of it which I present below.
If the reader will go back and study for a mo-
ment the manner in which adduction is performed,
in the article on the anatomy of the throat, he
will readily comprehend the explanation of the
subj oined picture. He will there see that there are
two adductor muscles; that one draws together
the two bones to which the cords are attached
behind (the arytenoid cartillages), whilst the other
revolves these bones inwards. Now in the sub-
joined case the arytenoid is the paralyzed muscle,
Fig. 16. Case of paralysis of one and as this body when acting normally draws
of the Adductor Muscles.
together the two arytenoid cartillages (A), hence
these two bones as shown above are widely separated, and as the vocal cords
(C) are attached to them these bands must likewise be separated (B). The
cords meet properly in the upper part of the drawing, because the other
adductor muscle not being paralyzed, is enabled to revolve the two cartil-
lages inwards in a normal manner.
THE
mptf Critic &
mm
With which is incorporated THE MUSIC TRADE JOURNAL.
NEW YORK, JUNE 5TH, 1881.
VOL. IY.
THE THROAT IN ITS RELATIONS TO SINGING.
A SERIES OF POPULAR PAPERS BY WHITFIELD WARD, A.M., M.D.,
TO THE METROPOLITAN THROAT HOSPITAL.
PHYSICIAN
XL
SOME OF THE MORE COMMON THROAT AFFECTIONS OF SINGERS, TOGETHER WITH
THEIR TREATMENT.
The following query is often put to me, why are singers more liable
than any other class of individuals to throat troubles? Simply because they
are continually using this portion of the human organism, which makes
it more susceptible to outside influence on account of the greater amount of
blood being attracted the parts.
In affections of the throat, the mouth may be only involved and the
larynx free from disease, or the larynx may be attacked the mouth escaping,
or what most generally happens, both the mouth and the larynx may be
attacked together. I will pass over the many diseases of the mouth as they
will be of little interest to the non-medical mind and allude to some of the
more interesting of laryngeal affections, which are commonly met with in
singers. The most common disorder in the laryngeal tube is an ordinary
simple inflammation, or as it is popularly termed a " cold." There are many
ways of taking cold in this the most changeable of all climates. Among
the prominent of which are, an untimely changing from a heavy to a lighter
texture of clothing or vice versa; sitting in draughts; the wetting of the
body, especially the feet; sleeping at night under open windows with an
insufficient amount of covering, &c., &c. A special cause with reference to
vocalists is, the passage from a warm apartment to the street, particularly in
cold weather, immediately after singing. The cold is contracted because
the vocal organs are temporarily congested—a natural consequence of sing-
ing—which renders the organ particularly liable to atmospheric action.
This subject has been fully discussed in the article entitled " t h e care of
the voice," and need not be again entered upon here. The most prominent
symptom of a common cold is hoarseness. The voice is hoarse in direct
proportion to the amount of inflammation. In some intense cases the voice
is utterly gone, the person so affected being unable to speak above a whisper.
The other symptoms, which will be instantly recognized by those who have
thus suffered, are a tickling of the throat and a greater or less amount of
cough according to the severity of the inflammation. In the treatment of a
common cold most any person will be able to give you one if not more reme-
dies that will, according to the ideas of the donator, assuredly effect a cure.
I n some instances when the nature of the affection is mild, simply confining
one's self to the house and enclosing the neck in poultices, or what not, as
we all know by personal experience, will be all that is necessary to effect a
cure in the majority of instances after the lapse of a varying amount of time,
say from a week to ten days. But in cases of professional vocalists, who
cannot afford to lay by for so long a period, other treatment than that just
alluded to is demanded. There is another and a great reason why singers
should have the proper treatment, and that is that a certain per cent, of
these cases of ordinary colds do not recover in themselves, but pass on to a
chronic inflammation of the larynx, a most persistent and troublesome affec-
tion, and one necessitating a regular course of treatment.
Therefore, although the non-professional may tamper with their throats
and trust to nature to affect a cure, the singer, whose livelihood depends
upon his voice, dare not run the risk, since the beginning of the breaking
down of many voices can be traced to some such effect as the above. There
is only one way in which inflammation, when it has taken hold of the inside
of the larnyx can be combated, namely: by the introduction of medicines
directly into the tube by means of little camels' hair brushes or sprays. In
this way the affected parts are touched and the disease conquered. To those
who have carefully read my foregoing papers, it will be superfluous to state
that medicines cannot be applied to the interior of the voice-box except by
means of the little mirror of the laryngoscope, since the parts are out of the
direct line of vision, or, to use literal language "around the corner." In
order to perform this little feat, the larynx must be displayed on the little
mouth-mirror, and the brush entered into the interior of the organ by means
of the image thereof. I would respectfully beg to say a few words to the
musical profession respecting the application of remedies to the larynx in
the way I have just described. Singers have a popular dread of being thus
treated, and this feeling is fostered by many teachers or voice-trainers
who instruct their pupils "never to let any one poke a brush down their
throats." This advice is absurdity and folly in the highest degree, and
can only be engendered by a total ignorance of the subject. If the
brush is properly used, and the right medicine is applied, I will
defy anybody to say that the voice can be thus harmed. If it were
so there would be no virtue in medicine, neither would there be any
use of spending years in studying up and perfecting one's self in this the
most interesting of the medical sciences. I will not deny that if the brush
is used by a person unskilled in treating the larynx or the remedies adminis-
tered be too strong or of a wrong nature, that harm might result to the suf-
ferer, but this is not the fault of the regular specialist, but rather of the
seeker after advice, who should see to it that they are in the right hands.
The dread which some singers have of the introduction of a brush into the
larynx is sometimes exceedingly laughable, and only equaled by the surprise
exhibited by the same individuals, when they ascertain by practical experi-
No. 9
ence, how simple the thing is when it is done properly. The sensations
experienced by the patient during the passage of the brush into the larynx
are of the most trifling nature, there being not the slightest pain caused by
the skillful operator.
There is one point on which I must strenuously advise the sufferer
with a cold, and that is not to sing while hoarseness exists. That soma
teachers make their pupils sing while the voice is in this condition, is a well-
known fact. Why they do this I am unable to state, except it is their
love of gain. Many of the chronic affections which are so frequently found
in the throat, are no doubt caused by such acts of in judiciousness as this.
In conclusion I cannot lay too much stress upon the importance of singers
attending to the affection above described, as a few applications at the right
time might save a tedious course of treatment, extending perhaps over sev-
eral months. A chronic inflammation of the larynx, or as it is technically
called, chronic laryngitis, is an exceedingly troublesome affection. It is also
often very insidious in its development, generally occupying from two to six
months. Its prime cause is a neglected cold or a series of neglected colds.
The vocalist afflicted with this disease gradually notices that the voice is not
the same as it used to be; that the high notes are difficult te take and some-
what blurred; that a much greater effort is required to produce tones that
could hitherto be sounded with extreme ease; that the richness of the voice
is considerably diminished; and that execution is more labored. In fact to
speak in a general way, the voice is giving out. If the above symptoms are
accompanied with a slight hacking cough and a persistent tickling of the
throat, together with a dryness of the parts, and the expectoration of a frothy
matter, the person so affected may rest assured that he has this disease.
Unless the affection is arrested by the proper course of treatment, the signs
above enumerated are bound to become intensified, which will sooner or later
altogether destroy the singing voice. In ordinary cases the talking voice is
not so much affected, but in some severe types of the disease, it is markedly
influenced and sometimes altogether gone. A most common cause among
singers for this variety of laryngeal disease is a strained voice. When pro-
perly used the vocal cords can perform a remarkable amount of work, but
when abused these delicate bands will soon show the effects of the maltreat-
ment by failing to respond when called upon. The most common effect of a
strain of the voice is a giving way, or a relaxation of the cords. Naturally
the two vocal cords when they are. brought toge-
ther present a very firm appearance. Now if these
bodies are relaxed, they will be seen to be very
flabby when they are abducted or approximated.
This manifestation will be instantly understood by
gazing for a moment on the subjoined pictui'e and
comparing it with the natural firmness of the vocal
cords as shown in Fig. 10.
Another prominent effect produced by the same
Cords.
^f
order that the cords shall vibrate properly—an
element which, as already shown, is absolutely necessary to vocalization—
they must be very thin, consequently if they be abnormally thick a proper
vibration of them will be out of the question, hence the voice will be seri-
ously impaired. As has been already stated with reference to the treatment
of ordinary colds, chronic laryngitis can only be cured by the direct appli-
cations of medicines to the diseased organs through the agency of brushes
or sprays. A paralysis of one or more of the vocal muscles is quite fre-
quently seen as a direct result of an abuse of the voice. Any of the vocal
muscles may be thus affected, the principal ones involved, however, being
the set known as the adductors or approximators of the vocal cords. A most
interesting case of this variety of throat affection occurred to me in my prac-
tice a little less than a year ago. The case referred to was that of a delicate
young lady, aged about 18, a pupil of one of the conservatories in this city.
Upon questioning her I ascertained that although her voice had been good
up to within three or four weeks, at the time of her examination it was impos-
sible for her to utter any musical sound except with the greatest effort. Acts of
talking also produced a considerable amount of pain. Upon a laryngoscopic
examination I readily discerned the cause of all her difficulty, namely: an
imperfect adduction or approximation of the vocal cords due to a paralysis
of one of the adductor muscles. The case was of such interest that I had a
drawing made of it which I present below.
If the reader will go back and study for a mo-
ment the manner in which adduction is performed,
in the article on the anatomy of the throat, he
will readily comprehend the explanation of the
subj oined picture. He will there see that there are
two adductor muscles; that one draws together
the two bones to which the cords are attached
behind (the arytenoid cartillages), whilst the other
revolves these bones inwards. Now in the sub-
joined case the arytenoid is the paralyzed muscle,
Fig. 16. Case of paralysis of one and as this body when acting normally draws
of the Adductor Muscles.
together the two arytenoid cartillages (A), hence
these two bones as shown above are widely separated, and as the vocal cords
(C) are attached to them these bands must likewise be separated (B). The
cords meet properly in the upper part of the drawing, because the other
adductor muscle not being paralyzed, is enabled to revolve the two cartil-
lages inwards in a normal manner.
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