terest, known as hysterical paralysis. It is usually only temporary,
and is sometimes produced in singers whose nervous condition grows upon
itself until the system passes into the trying disturbance diagnosed by
the rudely critical public as "stage-fright." Artists of marked
pretension have been compelled to abandon a public career because of
this affliction. There are other examples of it even more difficult to
understand. I have in mind a case of a singing-teacher in a conventual
school, who was under a peculiar strain of preparation for the
commencement exercises of the school and of her own class and their
appearance in public. She brought her class up to the appearing-point.
Then her nervous system gave way, and when she came to me she was
absolutely voiceless. Sometimes in coughing her vocal cords could be
seen to move. With rest she recovered, but she has a recurrent tendency
to the same trouble every year. The case would seem to illustrate
the uselessness of all effort on the part of the person so affected
permanently to overcome it. The remedy is at hand, however, in numerous
cases, in resort to a careful and uninterrupted upbuilding of the
nervous system.

I will mention some other cases of vocal disorder and cure. An operatic
tenor came to me with a tendency to break in scale-sounding, and with
a nasal or catarrhal color to all his tones above E. I found attached
above and back of the soft palate a mass as large as a hickory nut and
completely blocking up the dome of the pharynx. A little cocaine was
applied, and with a single sweep of the curette he was minus an adenoid
on the third tonsil, a tonsil of Luscha. Within ten days his voice was
completely restored.

Sometimes the physician is obliged to seek far for the cause of
catastrophe to the voice. A fine and thoroughly well-trained tenor
singer came to me with a singular tremor in his voice. The entire scale
was tremulous. I found nothing the matter with any part of his vocal
tract save that, on closely studying the condition of his mouth, there
was a rapid muscular contraction of the soft palate and surrounding
tissues. This led me to examine him from head to foot for possible
nervous disorder, of which, however, I found no trace. Then, satisfied
that there must be a more remote physical cause, I pushed the
examination further and discovered traces of kidney affection. He was
successfully treated for this and, with its cure, his voice also was
restored