was
tried repeatedly with the vowels _a_, _e_, _i_, _o_, and _u_, and
with consonants prefixed, but invariably with the same result. Upon
examination, no deviation from the normal anatomy was found, save in the
left anterior nostril. Here a sharp spur of bone projected from the
septum into the turbinated tissue. This condition had remained in this
singer for four years, according to my previous observation, without
causing her any inconvenience. A similar condition was seen by me
in the case of Mr. Santley, the famous English baritone, when I made
an examination, and he declared that he was not aware of its producing
even discomfort--such a capital illustration of the necessity for
non-interference until the laws of reflexes are disturbed, that I cannot
refrain from alluding to it.

In my patient, however, in addition to her nasal trouble, I found an
enlarged follicle about the size of a pea back of the posterior pillar
of the pharynx, at the junction of posterior pillar and pharynx. This
follicle was removed by a simple process, when, as if by magic, the
G sharp responded and has since remained unimpaired. My explanation
of this case is simply one of reflex action; that is, by a singular
complication this follicle fell in the track of the glosso-pharyngeal,
the pharyngeal-plexus, the external-laryngeal and the recurrent
laryngeal nerves, which, as it were, sounded the alarm for retreat of
the phonating muscles whose harmonious action was necessary to produce
the medium G sharp.

There are numerous instances of affections of the vocal cords that might
be cited, all superinduced by straining the voice from various causes,
but especially by using the voice under improper physical conditions or
of singing in rooms filled with foul atmosphere.

CHAPTER XII

NODES AND THEIR CURE

I use the scale of E as a means of revealing to the ear points wherein
the voice shows signs of failure. I use this scale because within it lie
all the principal resonances involved in voice-production. By this I
mean that somewhere between the interval G# to C# an oral resonance is
developed in the majority of voices. This seems to be coincident with
the action of the lips, the tongue and the soft palate, and the other
muscles that go to increase or to decrease the size of the oral cavity.
From C# to E above middle C the principal changes occur which contribute
to the development of the nasal resonance. Some rare voices, however,
con