PATHOLOGICAL VARIATION IN VOICE AND SPEECH. 617 



(D) Consonants of the Fourth Articulation-position. 

 Logically, the glottis itself may further be considered as a fourth 

 articulation-position . 



1. An explosive consonant is not produced by forcing open the glottis, 

 if a vowel has been loudly intonated from a previously closed glottis. 

 If this occurs during whispering, a feeble, short sound may undoubtedly 

 be heard, arising from the sudden opening of the glottis. As already 

 noted, the Greeks applied the term spiritus lenis to the utterance of 

 vowels from a previously closed glottis. 



2. The aspirates of the glottis are represented by the //-sound (hah), 

 which is produced with a moderately wide glottis. The Arabic Hha is 

 emitted with especial sharpness from a still narrower glottis. 



3. A glottis -vibrative occurs in the so-called laryngeal R of lower 

 Saxony, and in the Arabic Ain. It can be produced by pronouncing a 

 vowel with the deepest possible voice. This is followed by a distinct, 

 shock-like, resounding vibration of the vocal bands, which represents the 

 laryngeal -R. The sound is represented especially in the low German 

 dialect of Hither Pomerania, for example in Coarl (Carl), Wuort (Wort). 



4. A laryngeal resonant cannot be produced. 



The combination of different consonants is accomplished by the rapid, 

 successive execution of the movements necessary for each one. Com- 

 pound consonants are those that are formed by adjusting the parts of the 

 mouth for two different consonants at the same time, so that a mixed 

 sound is formed from the simultaneous production of both sounds. Ex- 

 amples: Sch, tsch, tz, ts, Ps (0), Ks (X, c). 



PATHOLOGICAL VARIATION IN VOICE AND SPEECH. 



Paralysis of the motor nerves of the larynx (from the vagus) as a result of 

 wounds or of pressure by tumors results in loss of voice or aphonia. In the 

 presence of aneurysm of the arch of the aorta the left recurrent laryngeal nerve 

 is often paralyzed in consequence of being greatly stretched. Rheumatism, over- 

 exertion, and hysteria may cause transitory paralysis of the laryngeal nerves. 

 Serous effusions into the laryngeal muscles in con- 

 sequence of inflammatory processes will also cause 

 paralysis of these muscles and thus aphonia. If 

 the tensors chiefly are paralyzed, monotonia of 

 the voice develops. The disturbances of respira- 

 tion attending paralysis of the larynx are worthy 

 of special notice. There may be no disturbance 

 so long as the respiration is quiet, but as soon as 

 the respiration becomes more active, a high de- 

 gree of dyspnea, such as Landois has observed 

 also in dogs, may set in, owing to the inability to 

 dilate the glottis. 



If only one vocal band is paralyzed, the voice FIG. 219. Tumors of the Vocal Cords, 

 becomes impure and falsetto-like. The dimin- 

 ished vibration on the paralyzed side of the larynx 



may even be felt externally, but it may be still better recognized by means of the 

 sensitive flame. It has been observed that unequal tension, from unequal innervation 

 of the tensor-muscles, may give rise to alternating vibrations of the two bands, 

 with opposite phases of movement. At times the vocal bands are paralyzed only 

 to such an extent as not to move during phonation, but only on forced respiration 

 and on coughing (phonetic paralysis). Mogiphonia, or premature fatigue of the 

 voice, is the name given by Frankel to a condition of paralysis of the laryngeal 

 musculature that consists in failure of certain coordinated movements that have 

 been acquired by practice. This corresponds to the paralytic form of writer's 

 cramp. 



