VOICE, SONG AND SPEECH. 271 



influence of the growth, was restored immediately, and the cough dis- 

 appeared a few days later, 



A still more serious injury to the vocal cords is due to ulceration 

 which has destroyed some part of the vocal cord. A defect of this kind 

 is irreparable. When an arm is diseased, no matter how seriously, 

 there is always a possibility of saving it, but when the arm is cut off, 

 its usefulness is ended. This is also the case with the vocal cords. 

 By means of training, the voice may to some extent be improved, but 

 it will always be more or less affected when there has been a loss of 

 substance. 



Paralytic conditions also have a marked effect on the voice. As 

 already explained, in the production of sound the edges of the vocal 

 cords are brought together. In cases of paralysis, if one or both vocal 

 cords can not be brought to the middle line, the space is too large to 

 resist the column of air from the lungs for setting the vocal cords in 

 vibration, and there is no voice. In some cases, where the paralysis 

 is on one side and not too great, the remaining vocal cord may be 

 gradually trained to be brought over to the other side, and in this 

 case the voice may be recovered, otherwise it will be simply a whisper. 

 Some cases of paralysis involve only the muscles which contract the 

 vocal cords, thus preventing tension and causing hoarseness. As there 

 is no loss of substance in paralysis, the prospects for recovery of the 

 voice, except in certain cases, is good. 



As we have already explained, the principal parts concerned in the 

 modification of speech are the lips, teeth, tongue, palate and nostrils, 

 and any defect in these will influence voice production. Some defects 

 are easily recognized, as for instance the tie-tongue, in which the band, 

 which connects the tip of the tongue with the floor of the mouth, is 

 too short and prevents the tongue from being brought forward in cer- 

 tain sounds, thus giving rise to the defect characteristic of this condi- 

 tion. This defect is easily rectified by a slight operation, and, unless 

 the muscles of the tongue are otherwise defective, restoration of normal 

 speech eventually ensues. 



It must be remembered, however, that in children who have for 

 years been accustomed to this defective method of speech, the muscles 

 have adapted themselves to the changed condition, and a complete cor- 

 rection of the defective speech is a question of time. I remember an 

 occasion, for instance, when a mother returned to me after this simple 

 operation had been done, and complained that it had been a total fail- 

 ure, giving as her reason that the child's speech was just as defective 

 as before the operation. I explained to her what I have just said, and 

 instructed her to teach the child to use its tongue in its normal posi- 

 tion, and this exercise was followed in a few months by an entire cor- 

 rection of the defect. 



