THE TREATMENT OF CERTAIN FORMS OF VO- 
CAL DISABILITY BY THE APPLICATION OF 
THE PRINCIPLES OF VOICE-CULTURE.* 
By S. LANGMAID, M. D., 
BOSTON. 
I HAVE chosen the subject of this short paper for sev- 
• eral reasons. It happens to have engaged my 
thoughts for some years. I have been constantly con- 
sulted in a class of cases in which it has been necessary to 
prove that the disability complained of was not due to dis- 
ease but to misdirected physiological actfon. because, also, 
that although much has been written explanatory of vocal 
phenomena, very little can be learned from books with re- 
gard to the essentials of voice-culture and the jfight method 
of restoring impaired vocal function. 
The subject might have been termed, " Something aboiit 
vocal gymnastics," and that expression may convey to some 
of you a clearer idea of what I have to talk about. 
Let me say here that I do not propose to discuss the 
acoustical and physiological qualities of the human voice 
except in the simplest manner. The anatomy of the 
larynx, the action of its various muscles, the nature of 
sounds and the laws which govern their production, are 
quite well known to all of you. 
The laws of acoustics and physiology have analytical, ex- 
planatory connection with our subject. The object of this 
paper has synthetical significance. The thing to be done is 
to restore what has been lost, not to account for what al- 
ready exists. If the results obtained are found to answer 
* Presented as a Candidate's Thesis to the American Laryngological Associa- 
tion, and published by the Council. 
♦Reprinted from the Archives of Laryngology, Vol. ii, No. 2, April, 1881. 2 
S. M. Langmaid. 
not only the requirements of art, but are in accordance with 
the known laws of physiology and the accepted theories of 
the nature of musical sounds, we shall have the double 
proof of the justness of our methods. 
I yield to none in my admiration and thankfulness for the 
discoveries of Helmholtz and other physicists, and I regret 
the lack of time and ability to pay a fitting tribute to 
Madame Seiler for her original and priceless exposition of 
vocal phenomena; but I am compelled to say that, as the 
full powers of the human voice were exhibited many years 
before such discoveries were made, it is more than likely 
that the methods of voice-production may be formulated 
without the help of the laryngoscope or the application of 
what is known of the laws of sound. That we are not with- 
out guides to such methods I shall show further on. 
To enable the singer to regain lost tones; to teach the 
beginner to produce each note of the scale in such a man- 
ner that the vocal organs shall receive no injury but rather 
gain strength'' by continued practice ; to correct a vicious 
production, such as has already impaired the organs and 
must necessarily result in the annihilation of the singing 
voice, some method must be known which does not necessi- 
tate a knowledge of physiology or the laryngoscopic ap- 
pearances of the glottis, on the part of singer or teacher. 
That there is need of such information, I think all laryn- 
gologists will admit. My own experience, as briefly given 
in the cases about to be narrated, leaves no room for doubt 
of its value for those who use the throat, and for those who 
would treat its diseases and disabilities. 
How diverse and conflicting published opinions are with 
regard to the proper method of vocalization, your own read- 
ing has shown you. 
One teacher says: " Sing upon the breath " (whatever 
that may mean); another, " Sing and feel no parts." One 
instructor advocates the glottis stroke, but another asserts 
that the coup de glotte will surely weaken and destroy the 
vocal organ. One physiologist affirms that the larynx rises 
for every note of the scale, but another says it descends for 
all notes above a certain pitch. Some say that the produc- The Treatment of Certain Forms of Vocal Disability. 
3 
tion of the vowel is based upon the action of the consonant- 
articulating organs, the name of such production being "ex- 
ploded vocality." On the other hand, it is asserted that 
the ineffectiveness of the singing voice in certain countries 
results from the multiplicity of consonants in the spoken 
language, the result being a weakening of the true laryngeal 
action. These are but a few of the various opinions which 
are to be met with in treatises on the physiology and 
hygiene of the singing voice. 
Where then shall we look for that which shall prove be- 
yond contradiction what may be considered to be a true 
way of producing musical tones? 
I know of but two sources of such information, viz.: 
great singers, and such teachers as have proved, by the re- 
sults of their labors, that they can cultivate the singing 
voice to the extent of its full development and lasting in- 
tegrity in any individual case. 
Information which I have obtained from personal inti- 
macy with exceptionally fine singers, and the scrutiny which 
I have given to the methods of all those whose public or 
private efforts I have witnessed, have led to this conclusion, 
viz. : that the means used by all successful vocal artists are 
identical; the variations in result correspond with the vary- 
ing success or manner of application of these factors, such 
success being influenced by the physical conformation of 
the artist, his musical aptitude or cultivation. [I may be 
pardoned for saying that my own artistic experience con- 
firms my belief in the truth of this position.] 
The question which interested us is how to use the instru- 
ment by which the singing or speaking voice is produced. 
The instrument exists, so wondrously constructed, capable 
of such varied functions that the human mind has as yet 
been unable to completely analyze its modes of action, and 
yet it is so perfectly adapted to the end for which it was 
made, that the possessor, no matter how uneducated, may 
play upon it for the wonder and gratification of the whole 
world, provided only that he is endowed with the still more 
wonderful gift of musical inspiration. 
The instrument of which we speak consists of three or 4 
S. M. Langmaid. 
more grand parts. The larynx with its so-called vocal 
cords capable of instigating sounding vibrations. The 
lungs, the cavities containing the air to be set in motion to 
produce the sounding vibrations. The respiratory muscles 
or levers for applying force to the parts to be set in mo- 
tion. The bronchial tubes, the trachea, pharynx, nasal cavi- 
ties, and the bones of the head, which act as resonators and 
reflectors. 
Each of these factors must be so perfectly used as in 
their combination to produce all the effects of which the 
voice is capable. 
Defects and shortcomings in vocalization may result from 
the wrong employment of any or all of these parts. 
1st. If the larynx is forced or allowed to remain in such 
positions as render the efforts of the glottis to produce the 
desired tones inoperative, except by some complementary 
wrong action, the result will be, sooner or later, loss of 
those particular tones. If the muscles which control the 
position of the larynx and glottis-opening are not used in 
their integrity, the resulting tone will have a corresponding 
deficiency. 
2d. If the reservoir of air to be set in motion is not 
allowed to act to its full capacity, the effect will be to lessen 
the amount of the real sound producer in the column of 
air. 
3d. If the respiratory muscles are not used to the great- 
est advantage, the result will be that which is always ob- 
tained by too short leverage. 
4th. If the reflectors are not made to vibrate, the great- 
est leverage or blast may be employed, with the vocal cords 
in the necessary position for any particular note of the 
scale, and the resulting tone will be inaudible at a greater or 
less distance. 
To name the acts necessary for the production of tone, 
is to formulate the defects and disabilities of the singer. 
The perfection of mechanism would be : The larynx im- 
movably fixed in its vertical and longitudinal position for 
the production of any given note of the scale of that par- 
ticular voice ; the lungs and their continuations in such The Treatment of Certain Forms of Vocal Disability. 
5 
condition as would allow them to contain the necessary- 
amount of air to be used in the particular vocal effect 
desired ; the respiratory muscles acting in such a way as to 
render the leverage perfectly adjustable to the amount of 
action desired; the column of air, of a certain vertical and 
longitudinal size, vibrating through given dimensions, must 
be made to impinge upon the necessary reflectors, and from 
them to be delivered to the mass of outer air to give rise to 
sound-conveying waves. 
One source of error for the singer and the scientific 
observer also exists in the wonderful compensating ability 
of the vocal instrument. Wrong action of one part is com- 
pensated for by increased or modified action of other parts, 
and the resulting imperfect or wrong mechanism is fre- 
quently mistaken for the normal one, the progressively 
destroying effect of which is not seldom discovered, when, 
unfortunately, wrong scientific theories have been published, 
or the disabled organ has lost its pleasure-giving or money- 
gaining attributes. Of the action of some of the parts con- 
cerned in vocalization, I shall have almost nothing to say, 
because much has been already accurately written about 
them. I must, however, emphasize the mechanism of other 
parts because they are more frequently disused, and because 
the substitution of compensating action is less easily 
detected. 
First, I shall speak of the position which the larynx 
assumes during the singingof the scale, from below upward. 
What is true of one kind of voice is true of all, since the 
form of the singing organ is the same for all species of 
voices; the only variation is in dimension. The same 
mechanism pertains to all; the direction of the movements 
must therefore be the same. 
There are no muscles peculiar to the soprano larynx,- 
none which do not exist in the bass organ also. 
The nerves are the same. The situation and gross form 
of the organ are the same in all voices. The only modifica- 
tion is that the smaller instrument is fitted to produce 
higher-pitched and more slender vocal effects. So true is 
this, that the observer who has carefully noticed the external 6 
S. M. Langmaid. 
and internal outlines of the singing organs can pronounce 
with certainty upon the kind of voice for which any organ 
is adapted. 
Here I must state that the notes throughout the scale 
can be produced in two ways, viz.: by force of blast or by 
muscular adjustment. This fact cannot be too strongly 
emphasized. 
Many of the most erroneous deductions have been based 
upon the fact that the successive notes of the scale can be 
produced by force of blast alone. Those who have experi- 
mented with the dead larynx have, all of them, so far as I 
know, formulated wrong doctrines as to what the action of 
the living larynx should be. The fact is that the extrinsic 
and intrinsic muscles of the larynx are quite capable of 
effecting all the changes in position necessary to produce 
all the notes of any voice. 
The proof is at hand, and can be supplied by any singer 
among you. Fix upon a note of definite pitch and then 
think of any note above it. A movement will be felt in the 
throat which is the adjustment of the larynx. Preserve 
that new position ; give the slightest impulse by the breath, 
just enough to set the cords in vibration, and the pitch of 
the note will correspond with the note which was prede- 
termined by the mind. The accuracy will be in proportion 
to the cultivation of the singing voice. 
Think for a moment how direct and simple this method 
is, compared to that which calls for an increased force of 
blast for every higher note. Who could accurately measure 
beforehand the exact quantity of breath necessary to pro- 
duce not only the thirty-six or more notes comprising the 
compass of good voices, but the great number of inharmonic 
divisions between these tones ? And yet this is the very 
method which is frequently taught, and is the means usually 
adopted by the untrained singer to enlarge the compass of 
the voice. From substitution of force of blast for normal 
muscular adjustment, arises much of the disappointment to 
which most of those who employ it are doomed. 
Another point claims close attention. Nothing can be 
more unprolific of good results than the directions to " Sing The Treatment of Certain Forms of Vocal Disability. 
7 
and feel no parts," or, as some direct, " Sing out, sing out." 
As well tell the cornet player to play out. The successful 
singer would say, " Feel all the parts," for through sensation 
comes knowledge of what is being done. Rather sing in, 
viz., use the reflectors. Place an india-rubber head over the 
larynx and what sort of a tone would come from it ? Every 
one admits the value of the hard structure of the head as a 
voice intensifier, but nowhere does one find in books definite 
rules for the use of those bony reflectors and cavities. To 
be sure, it is casually mentioned by one writer that the lower 
base notes get an increased resonance by being sung in the 
nose, and another says that the head tones are so-called be- 
cause they seem to be produced in the head; but I believe 
that no one could obtain information from such statements 
which would direct to the philosophical and artistic use of 
the reflectors. The fact is that the proper use of the reflec- 
tors is quite as necessary as that of any portion of the in- 
strument ; their non-use is equivalent to the removal of the 
pavilion of any brass instrument. How to use them is a 
part of the unwritten law of the art of singing. How they 
are used by successful singers may be learned from listening 
to Campanini, and was to be witnessed in the perfect method 
of Mad. Titiens. It is sufficient to say that every vibration 
of the glottis must find its corresponding vibration of a re- 
flector, and any note which is emitted without being so re- 
flected will be deficient in one or more vital qualities. The 
physicist will explain the nature of these deficiencies by 
means of analytical instruments; the singer has only sen- 
sation for his guide. 
A few words with respect to the employment of a vibrat- 
ing column of air of more or less definite vertical length, and 
I will briefly relate a few cases which exemplify what has 
already been said. 
If the scale is sung from below upward with full tone it 
will be noticed that a kind of vibratory thrill is experienced 
in the region of the sternum. With the low tones the situ- 
ation of the vibration is lower than with the higher tones, 
but it can be experienced even with the notes above the 
staff in the tenor and soprano voices. This I believe is S. M. Langmaid. 
8 
caused by the vibration of a column of air below the glottis, 
and as its position is largely under the control of the will, I 
believe that sensation may be used to regulate the dimen- 
sions of the column of air to be used under any circum- 
stances of pitch or volume of tone. 
One word more with regard to registers, so called, at cer- 
tain notes of the scale. In all species of voice, changes of 
quality of tone are noticed. The groups of notes which are 
all of one quality, are called registers. It may be said, how- 
ever, that the better the voice, the less noticeable are these 
differences of tone. These changes in quality of tone are, 
I believe, due to two causes: changes in position of the 
larynx and variations in reflection. The register called 
" falsetto " is due, in my opinion, to an abnormal, imper- 
fect use of the extrinsic and intrinsic laryngeal muscles. 
The tones are as abnormal in quality and power as the 
mechanism is imperfect which produces them. Such tones 
are never to be cultivated in the male or female voice. To 
cultivate them is equivalent to the deliberate manufacture 
of an imperfect musical instrument. 
In the following case, the above principles found their 
application for the restoration of the voice. This first case, 
and each of the others, may be considered as a type, and 
of many similar. 
Case i.-Miss A , 16 years old, a strong healthy girl, had 
formerly an excellent voice of large compass. She is very am- 
bitious and intends to become an operatic artist. She has re- 
ceived vocal instruction during six months from an Italian teacher, 
a graduate of a foreign conservatory. She has lately noticed 
that the tones above Fa on the staff were sung with increased dif- 
ficulty, and that attempts to sing were followed by aching of the 
throat. Parents, teacher and pupil were alike discouraged. Upon 
hearing the scale sung it was evident that the attempt to sing the 
notes above the staff was attended by a straining of the pharyn- 
geal muscles, caused by the endeavor to sing the group of notes 
above the staff with the laryngeal adjustment proper for the notes 
below. She was told to allow the larynx to rise, and to sing the 
note from the new laryngeal position. Instantly, all feeling of ef- 
fort disappeared, and these upper notes became, after some The Treatment of Certain Forms of Vocal Disability. 
9 
months, so easy in their production, and so beautiful that she was 
advised by an impresario to fit herself for the stage as quickly as 
possible, for such tones were rarely heard in Europe. 
The fault in this case was that the vertical position of the 
larynx did not correspond to the longitudinal position. 
Case 2.-Miss H. A. Has a voice of beautiful quality which 
she formerly used for her own gratification and that of her friends. 
Began to receive instruction in singing two years ago ; was taught 
a very definite method, but at the end of the year such weakness 
of tone was experienced at the note D. on the staff and on all 
above, that she ceased to sing. After some months she became 
the pupil of another teacher who advised her to consult me for 
what seemed to be a "sort of paralysis of some throat muscles." 
The weakness in this case was due to the cultivation of the falsetto 
production on the note D., a production which, from its seeming 
ease and resulting flutey quality of tone, is a most seductive one. 
A few minutes' instruction in the manner of raising the larynx and 
applying the necessary amount of tension was enough to remove 
not only the feeling of weakness of the throat, but to inaugurate 
a way which simply needed practice to insure continually increas- 
ing power and vitality of tone. One characteristic of the cultiva- 
tion of the falsetto tone is the inability to cause it to gain in power ; 
it remains forever incapable of translating any emotion except 
that of weakness. 
Case 3.-Mr. W., a tenor singer with a voice of nearly three 
octaves, complained of frequently disabled throat from attempts 
at singing, and lately of almost constant slight hoarseness. He 
was a man of powerful frame, with breathing capacity much 
greater than common. 
The pharynx was congested, the vocal cords somewhat red- 
dened, and pains were complained of in the region of the pillars 
of the fauces, and aching in the larynx, at times. 
It was found that two great defects existed in the production of 
tone in this case : 
The upper tones were obtained by force of blast, and the re- 
flection of tone was a matter of accident. 
Misdirected force was used not only to obtain the notes, but 
also to increase their power. The physical strength of the patient 
enabled him to get by main force what should have been obtained 10 
S. M. Langmaid. 
by nicely adjusted exercise of power, and the result was in pro- 
portion to the singer's ability to wrongly and continuously apply 
this strength. 
Complete disuse of the singing voice was enjoined. The con- 
gestion of the mucous membrane was treated by the application 
of various stimulants and astringents, and the return to a healthy 
condition was not long delayed. A few exercises were given with 
the object of securing the proper action of the laryngeal muscles 
(such as a quick reflection of every tone, singing with closed 
mouth, articulating the vowel by causing it to follow quickly 
after labial consonants, and insisting that every note of the scale 
should be produced with exactly the same force of breath). 
The result was all that could be desired. The throat has 
remained well for several years. 
The number of cases is large in which suggestions as to 
the natural use of the voice (and the natural is the artistic) 
have not only enabled the singer to increase its power, and 
beauty, and compass, but have caused also the disappear- 
ance of pathological conditions, such as congestions of the 
pharynx, swelling of the membrane covering the arytenoids, 
congestion of the cords, and physical discomforts of various 
kinds.