Frank E. Miller

HYGIENE OF THE VOICE

I should say that no one should be more scrupulous in his habits than the singer. It is more difficult to keep the keen edge of the voice in good repair than that of the sharpest razor, and nothing should be done to dull it. No one more than the singer requires to observe the moral and physical laws. The singer should always be in training, always in the pink of condition. By nature, women should be more subject to impairment of voice than men. But they are not. They are brought up to take better care of themselves and, to put it bluntly, to behave themselves better. As a result, in spite of recurring disorders, they stand up and do the work demanded of them when men do not or cannot.

Every pupil should be instructed to fall naturally into an attitude of attention when coming into the presence of the teacher—as much so as in the presence of a distinguished host or hostess. Morale, esprit de corps, cannot be instilled too soon. They may well be considered psychical elements in general vocal hygiene.

Personal cleanliness is, of course, one of the first requisites to health. But, while bathing should be regular, it should not be extreme. A cold bath stimulates at first, but is followed by a bad reaction in a few hours. A hot bath, followed by exposure to the open air or a draught, is apt to develop a cold by night. I recommend for singers a lukewarm bath.

When singers have had their hair cut, they should watch themselves carefully for the next twenty-four hours. If possible, they should have it cut shortly before going to bed and should protect the head with a light hood. Some singers catch cold every time they have their hair cut, and bald-headed singers always are catching cold. And while on this subject, it cannot be stated emphatically enough that any hair tonic that stimulates the scalp too much is bad. The glands in the scalp absorb the lead, cantharides, cayenne pepper, or whatever the specific poison in the tonic may be; this is carried to the respiratory tract, and creates the symptoms of a cold.

Singers are not apt to take much exercise. For this reason they should be careful in their diet. They should avoid beef, lamb and mutton. The white meat of fowl is the best meat diet for the vocalist. Milk, eggs, toasted bread, string beans, spinach, lettuce, rice and barley are excellent. Potatoes should be mashed, with milk and butter. Fruit is better taken stewed and with little sugar. Ice cream clears the voice for about twenty minutes, but the reaction is bad.

Regarding tea and coffee, inasmuch as a singer is not a cat on a back fence, but a human being, there is no reason why he should not be permitted to follow the social law in respect to these, provided he is not a sufferer from indigestion. In fact, there are times when a cup of coffee taken at the right moment will carry a singer, tired from travel or other cause, over a crisis. There can be no harm in a cup of coffee (Java and Mocha mixed), a cup of Phillip's Digestible cocoa, or a cup of tea (Oolong or Tetley's Ceylon) for the singer who is in good condition.

I always have held that a singer could drink a small quantity of alcohol—claret, for example—if he takes with it enough lithia or other alkaline water to counteract the acid in the wine. Smoking, however, is very injurious. A famous tenor of to-day whispered during a performance in the Metropolitan Opera House to the prima donna in the cast, "I smoked too many cigarettes yesterday; I feel it in my voice." Myron W. Whitney always left off smoking for two weeks before the Worcester Festival.

For travel the singer should be prepared for atmospheric changes as no one else in the world. He should be especially cautious at night. A singer who filled an engagement in Savannah started from there for the North at night. He had been in perfect voice. As the night was warm he left one of the windows of his berth open. At Washington he woke up with cold. It was snowing, and snow had come in through the open window on to his berth. His nose was "stuffed." He had no voice when he reached New York. This was due to the sudden intensification of all the things that belong to a cold. If he had worn a dressing-gown with a hood—not necessarily a heavy one—that would have saved him. A garment of that kind should be worn by singers at night when traveling. They can regulate the bed-covering accordingly, so as not to be too warm.

Clothing should give correct aeration for the season. Silk underclothing I regard as dangerous, because silk is a non-conductor. Good Lisle thread or flannel giving proper aeration is excellent. No one should be more careful about their clothing than New Yorkers, because of the sudden changes in temperature there. Stiff, high collars are injurious, because they are irritants to blood-vessels and nerves and are non-conductors. Collars should be worn from a quarter to half an inch away from the skin, for the less the Adam's apple—the highest forward point of the larynx—is irritated, the better.

There are certain periods of the year and even one special day when singers should especially look out for their voices. From January 15th-20th is the period of January thaw and of colds from melting snow. From March 19th-25th the earth is beginning to ferment and this is a period for spring fever and intestinal troubles, which indirectly affect the voice. May 9th usually is cold and rainy. The latter part of May and nearly all June, rose cold or June cold is prevalent. About August 1st come the dog days and hay fever. In fact, from August 1st until the autumnal equinox is an anxious time for the singer. From November 11th-25th there is apt to be alternate cold and warm weather conducive to asthma.

With the singer, more even than with any one else, the ounce of prevention is the pound of cure. The first sneeze should send the singer to his physician; and he also should realize—as only too few people do—that after a cold nature requires from a week to nine days to repair the damaged processes, and that he should not work too soon. Rest is a great cure.

One of the most distinguished French laryngologists, Dr. G. Poyet, was interviewed for the European edition of the N. Y. Herald on the subject of hygiene for the singer. Although what Dr. Poyet says on some points is a repetition of matters already gone over here, while other points will be more thoroughly gone into than was possible for him in the space at his command, a summary of what this clever man had to say on a subject of such importance to the singer will serve capitally the purpose of this chapter.

Dr. Poyet began by saying that, since the voice has intimate relationship with the entire organism, it follows that a well-understood hygiene should concern the totality of the functions. First of all, it is indispensable to avoid any cause of disturbance of the circulation, and particularly of the pulmonary functions.

"The singer, as much as possible, should inhabit sufficiently large apartments. He should avoid rooms warmed by apparatus which may produce carbonic acid or which remove from the air the watery vapor it contains normally. Every day on rising he should practise exercises in deep breathing and, if possible, some of the gymnastic exercises which it is possible to practise in a room. Walking is undoubtedly the best exercise, and every singer who is careful of the soundness of his lungs—which is equivalent to the soundness of his voice—should walk for an hour every morning before his repast." (This advice of Dr. Poyet can hardly be taken literally, and should be determined largely by the physique of the individual.)

In order to avoid colds, bronchitis, sore throat, catarrhal laryngitis, the singer should regulate in a fitting manner the thickness of his clothing in accordance with the prevailing temperature. If by misfortune he catches cold, a little laryngitis, a coryza, all of which cause hoarseness, he should immediately abstain from singing. Neglect of this rule may bring about the persistence of vocal accidents often very long in curing. It is because professional singers cannot interrupt their work in such cases that they more often than any others suffer from laryngitis and above all in the so dangerous form of chronic inflammation of the vocal cords, which determines the deplorable "singers' nodules."

The cutaneous secretions should be watched in persons who have need of a clear voice. Almost all catarrhal affections of the respiratory organs are due to chills. Advice is therefore given to every person who has practised violent singing-exercises, which cause perspiration, immediately to change his clothing after having been rubbed down with a horsehair glove or with flannel sprinkled with alcohol.

Like the respiration, the alimentation ought to be watched by the singer. As much as possible during the process of digestion no violent or prolonged singing-exercise should be undertaken. Digestive troubles are often the cause of deterioration of the voice, either because the swelling and distension of the stomach by gas trammels the play of the diaphragm, and consequently that of the lungs, or because intestinal troubles bring on constipation or diarrhoea.

Very nutritive and very digestible food should be chosen for a singer, and a mixed alimentation should be employed. Among drinks preference should be given to wine and beer. Alcoholic liquors, Dr. Poyet thinks, should be absolutely forbidden. However, he advises a singer in the course of a fatiguing performance sometimes to moisten the throat with, and even to take a few mouthfuls of, cold water, to which has been added a little old cognac or "vin de coca"; but never, on any account, to take an iced drink just after singing.

Everybody who sings ought first to observe in the strictest manner the rules of general hygiene. Thanks to this hygiene it is possible completely to develop all the faculties of the larynx and to regulate the voice in such manner as to assure its regular operation. General hygiene, moreover, will permit the singer to preserve himself from the external influences which may bring about aphony or dysphony, that is, loss of voice or difficulty of voice.

A person who sings should always assume a natural attitude, since this aids the play of the respiratory organs. This play should be mixed, that is to say, costal and diaphragmatic. The respiration should be well regulated. The singer ought never to take too sudden inspirations, for he would thus run the risk of rapidly irritating the vocal cords. When it is a question of vocal exercises, one always should proceed from the simple to the complex, taking care not to prolong the exercises at the beginning. That is, the first singing-exercises should not be too prolonged. Moreover, in these first exercises the singer should never attempt to attain the extreme notes of his vocal range. The exercises should lie in the middle register.

Keen impressions, whether of joy or pain, are, in Dr. Poyet's opinion, bad for the voice. Great fear may cause a passing but instantaneous loss of voice. "Vox faucibus hÆsit." The emotion of singing in public, as everyone knows, prevents many artists from showing their full capacity. Only custom, and sometimes reasoning, can free them from "stage-fright."

People who sing, and who desire to preserve the integrity of their voice, should abstain from smoking. Because some singers—Faure, in particular—have had a brilliant career despite the inveterate use of tobacco, there is no reason that this example should be followed. Tobacco irritates the pharynx, reddens the vocal cords, and may cause heart troubles harmful to singing.

Pungent scents should be proscribed for singers. The odors of some flowers are for certain artists the cause of persistent hoarseness. Mme. Carvalho could not endure the scent of violets, which instantly caused her to lose her voice. Scents often determine a rapid congestion of the mucous membrane of the nose to such an extent that in certain persons they cause veritable attacks of asthma. Dr. Poyet also puts singers on their guard against scented toilet powder. "I knew," he says, "a great singer who was obliged to renounce the use of the toilet powder called 'À la MarÉchale.'"

In ending the interview, he calls attention to the fact that the larynx, while very delicate, is an extremely resistant organ, since it can face fatigues that no other human organ could support; but because it shows signs of fatigue only by hoarseness, is no reason to call on it for too prolonged efforts. "To work two hours a day, either in study or in singing, seems to me a maximum that should not be overstepped by a person careful of his vocal health."

Another distinguished foreign specialist is Dr. N. J. Poock van Baggen, of The Hague, Holland, who has contributed to the Medical Record a series of articles on throat diseases caused by misuse of the voice, and their cure.[A]

Clergyman's sore throat, as Dr. Van Baggen says, is a disease known to every throat specialist. "It is produced by misuse of the voice, and the same disease, often in more aggravated form, is produced in the singer and by the same cause. The patient, after singing, will experience a dry and hot feeling in the pharynx and larynx, irritation, and a frequent cough. Examination of the patient discloses catarrh of the pharynx and of the larynx; congested and swollen mucous membrane; pillars of the fauces swollen and unduly developed; all these symptoms accompanied by paresis of the vocal cords, which are red or yellow and do not approximate well. To this paresis of the cords is united a paresis of certain muscles of the larynx; to which is added, in serious cases, a swelling of the aryepiglottic ligament."

That this disorder is not organic, but functional—not caused by enlarged tonsils, adenoids, nasal polypus or malformation of the tongue, but by misuse of the voice—can be proved by the beneficial effect produced upon the organs by complete rest from singing; the symptoms sometimes disappearing entirely, only to reappear, however, when singing is resumed—further proof that misuse of the voice is at the root of the evil.

"Dividing the muscles into those used in breathing, in articulation of consonants and in vowel enunciation, the physician will find that in his patient there is no proper coÖrdination between these three groups of muscles—that through faulty respiration and articulation the respiratory and articular muscles fail to support sufficiently the vocal muscles, with the result that the vibration of the vocal cords is weakened. One fault begets another. The faulty use of the respiratory muscles directs the vibrating air-column to the soft palate, where the tone is so smothered that the singer has to over-exert himself to be heard, instead of directing it against the hard palate, where it would gain vibrance and carrying quality."

The faulty use of the muscles of articulation is disclosed when the back of the tongue rises like a flabby partition between the opening of the mouth and the pharynx, the consonants being formed thereby far back in the mouth, instead of forward with the tip or middle of the tongue leaning against the hard palate. The articulation is, in consequence, thick and dull. The vocal muscles are contracted to an unnatural degree, and every vocal tone is accompanied by an audible shock or spasm of the glottis. All this adds to the exertion required of the singer to make himself heard, an exertion and strain which eventually result in the symptoms that have been described, and which most singers believe due to colds and other troubles, whereas they are the result of the singer's own misuse of his voice.

I have said that correct breathing is one of the fundamentals of correct voice-production. No wonder, therefore, that incorrect breathing is one of the most potent factors in the misuse of the voice that sends the singer as a patient to the physician. I have stated that there are three kinds of breathing—clavicular, costal and diaphragmatic; and these have been described. It has also been pointed out that the teacher who instructs in one kind of breathing to the exclusion of the other two makes a serious mistake. For in correct breathing, all three are coÖrdinated. Usually it is spoken of as mixed costal and diaphragmatic. In truth, however, it is mixed costal, diaphragmatic and clavicular; but, aside from the awkwardness of combining all three terms in characterizing correct breathing, the clavicles play a less important part in it than the diaphragm and the ribs. In their relative importance to correct breathing the diaphragm comes first, the ribs next and then the clavicles. I feel certain that Dr. Poyet means the coÖrdination of the three when he speaks of mixed costal and diaphragmatic breathing, and that Dr. Van Baggen also means this when he speaks of diaphragmatic breathing. In fact, his description of diaphragmatic breathing involves the ribs; and if he omits mention of the clavicles, this may be explained by the slight part they play in correct breathing, merely topping off, as it were, the action of diaphragm and ribs.

Dr. Van Baggen, in the breathing-exercises which he describes as beneficial for restoring a voice impaired by misuse, lays emphasis on the control of expiration and on the brief retention of the breath before exhaling it. In his first exercise the abdomen is pushed forward and contracted, the idea of breathing being excluded in order to concentrate attention upon making the movements correctly.

The second exercise consists of these same movements, but now combined with inspiration and expiration through the nostrils. When first started, the exercises are limited to a few minutes four or five times a day. When this method of breathing has become natural to the patient, there is added the brief retention of the breath and expiration under control—that is, gradual expiration. This constitutes the third exercise.

In this it is recommended to inhale slowly through the mouth, which should be in position to pronounce f, that is, not too open. Hold the breath while mentally counting three. Exhale, pronouncing a prolonged s and finishing on t. The pronunciation of f during inhalation and of s and t during exhalation is advised in order to provide evidence that inhalation and exhalation are carried out evenly and without shaking or breaks.

Built upon this is the exercise for teaching the vocalist to inhale quickly, hold his breath a brief space, and exhale as slowly as possible, as must be done in singing. The inspiration now is through the nostrils; the pause is not quite so long, but the expiration on s and t is longer—say as mentally counting 40 would compare with counting 10.

Whoever has read carefully the chapters on breathing in this book will have discovered by this time that the breathing-exercises just described lead up to the principles of artistic breathing set forth in those chapters; and that whoever has read them and will carry them out never will require breathing-exercises to correct misuse of the voice from that source, because his breathing will be absolutely correct. The same is true of the exercises given by Dr. Van Baggen to make the breathing-muscles coÖperate with the articulation and vocal muscles. Nevertheless, since there are people who do not read carefully, or who go along in the same old faulty way until brought up suddenly by the dire effects of misusing the voice, I may add that Dr. Van Baggen's exercises for articulation will be found in detail in the pamphlets mentioned.

When a singer who is suffering from misuse of the voice comes to a specialist for treatment, the specialist must for the moment become a singing-teacher and instruct the singer in the artistic coÖrdination of breathing, articulation and vocal muscles. The patient, having gained proper breath-control and having had impressed upon him the importance of forward placement and of the normal position of the tongue to correct articulation of consonants, is ready for correction of the faulty action of the vocal cords. This faulty action is due chiefly to faulty attack—a faulty coup de glotte—manifest mainly on initial vowels in an audible stroke, shock or check and in the emission of unvocalized breath. This latter is the so-called spiritus asper, because the emission of unvocalized breath which precedes phonation gives an aspirated or h sound, so that, instead of ah, we hear haa. The spiritus asper is caused by a too slow contraction of the vocal cords and their too gradual approach for phonation.

In the audible shock of the glottis (sometimes called the "check glottid") the vocal cords are pressed together and the retained breath causes a shock or explosion. Dr. Van Baggen says that the vowel which is thus formed might be called an articulated vowel, which accurately describes the effect, the vowel being enunciated with the circumstance of the articulated consonant instead of with the ease of the phonated vowel.

With a normal attack—the spiritus lenis in contradistinction to the spiritus asper—the glottis is in position for phonation at the moment breath passes through it. No unvocalized breath precedes it and no explosion follows it. The vowel-attack is clear, precise and distinct. Not only is the voice-emission pure, but there is no needless fatigue of voice, because all superfluous movement of the glottis is avoided.

The "check glottid" or glottic shock, on the other hand, involves an undue effort of the vocal muscles, and the compression of the vocal cords causes irritation. The audible shock of the glottis cannot be avoided when it is necessary to accentuate a word beginning with an initial vowel. Constantly used, however, it is part of the misuse of the voice. Dr. Van Baggen recommends, as a method of correcting the too frequent use of the audible shock, that when a word beginning with an initial vowel appears in the middle of a phrase, this word should be united to the preceding one, somewhat after the manner (but more lightly) of the French verbal "liaison," in which the final consonant of a word becomes the initial consonant of the following word beginning with a vowel. For example in "vous avez," the s of "vous" is drawn over to and pronounced with the a of "avez," the effect being "vou-z-avez." If the phrase that is to be sung commences with a word beginning with an initial vowel, care must be taken to employ the normal coup de glotte, or spiritus lenis.

Although I have devoted two chapters to the registers of the voice, I shall also quote Dr. Van Baggen on the faulty use of these and the physical ills that result therefrom, since there are but few singers who do not know the difficulties which the registers of the voice offer; and many who spoil their voices forever by the misuse of those registers. Generally, the misuse consists in the exaggeration of a lower register at the expense of the higher; that is, in order to produce "big tone," forcing a register up instead of bringing the higher one down. Especially with dramatic singers, this fault is frequent. There is no voice, however strong it may be, which can endure this overstraining of the registers, and sooner or later the singer must experience the disastrous results of his or her fault—hoarseness, fatigue, roughness, and impureness in singing, and last, but not least, premature wearing out of the vocal organs.

The exaggeration of the registers is generally united with faulty breathing, which first of all must be corrected. Only after good results have been obtained with regard to breath practice, can exercises for the correction of the use of the registers be made with success.

When the fault consists in the exaggeration of the low register, the singing in this register must be avoided for some time; when both the low and middle registers have been used beyond their limit, exercises can at first be sung only in the high register.

The pupil, while practising (in the first case in the middle and high register, in the second only in the high register), must limit himself to a few tones, singing always downwards and very softly. The tones will be weak, husky, and often impure in the beginning; by and by, however, they will improve. When those few tones are pure and clear, the pupil may extend the exercises downwards, always singing pianissimo and avoiding the lower register. The high and middle registers, or only the high register, must be extended downwards as far as possible. Only after all the tones, sung as indicated, are clear and pure and have gained sufficiently in strength, may the low or the low and middle registers be used again, but even then not more than is strictly necessary.

The extending downwards of a higher register is also an excellent help in smoothing out the break in the voice at the passage from one register to the other. This extending downwards of the higher registers always can be done without any danger to the voice. The "timbre" of the voice will even gain considerably in brilliancy and fullness by exercising in this way.

Closely united to the stretching and relaxing of the vocal ligaments is the moving up and down of the larynx. Many believe that the larynx must be kept as motionless as possible and in a low position. The large number of voices which have been spoilt by this unnatural fixed position of the voice-box are a manifest proof of the evil of this way of operating, against which every singer must be warned.

The larynx must be completely free in its movement, its positions varying according to each tone and to the pronunciation of each vowel. We can easily follow the movement of the larynx by laying the finger on the prominence in the throat formed by the junction of the two wings of the thyroid cartilage, commonly called "Adam's apple." When pronouncing successively "oo, ow, oh, ah, eh, ay, ee," we shall notice that the voice-box rises and inclines slightly backwards; and, while at "oo" its position is lowest, it is highest at"ee."

Also when singing upwards we feel the larynx going up, while the inclination backwards can be observed even better than when pronouncing the vowels. Especially when singing a high tone after a low one we can feel how considerably the position of the larynx changes, and it is clear that every obstruction in its movement hinders normal voice-production.

When examining the patient the physician should observe the action of the larynx and feel if there are no spasmodic movements and if the flexibility is satisfactory. The action of the larynx can be exercised and improved by singing seconds, thirds, etc. The keynote always may be sung on oo; the second, third, etc., onee.