314 SIR CHARLES BELL ON THE ORGANS OF THE HUMAN VOICE. 
which rings through the nasal cavities after the closing of the passage through 
the mouth. 
From the same misconception of the actions which combine to form the 
voice, it may be, that grammarians do not give us a very clear account of em- 
phasis and accent. We perceive that there are two sources of the force with 
which the words are uttered, — the chest, and the pharynx. The emphatic de- 
livery of several words or syllables must proceed from the forcible expulsion 
of the breath by the effort of expiration; but the emphasis on the single syl- 
lable, and the forcible enunciation of the letter on which the clearness and 
distinctness, and sometimes the meaning, of words depend, must be produced 
by the effort of the pharynx. 
Proofs of the Correctness of the Opinions advanced, drawn from the effects of 
accident and of disease occurring under the Authors observation. 
1. A child having drawn the broken shell of an almond into its windpipe, 
was in momentary danger of suffocation ; and could utter no sound until the 
shell was extracted by incision*. 
2. Owing to disease of the glottis, it was necessary to open the membrane 
between the thyroid and cricoid cartilages ; the voice instantly ceased ; and 
no sound could be produced, while the air passed freely from the wound : “ the 
harsh sawing sound of the air in the contracted glottis immediately ceased, 
and the air played easily with a sibling sound through the wound.” 
3. A small pebble having fallen into the glottis of a child, there was a stridu- 
lous sound in drawing the breath, but no voice in the expulsion of the breath. 
4. When an ulcer had destroyed the margins of the glottis, and the sacculi, 
the patient spoke in a husky whisper, “ reedy and very feebly.” 
5. Thickening of the membrane of the glottis and epiglottis had a similar 
effect, the person speaking painfully in a whisper. 
G. A man died of suffocation from a pustule, which formed on the margin 
of the false glottis ; whilst he breathed, the sound was like the noise of a saw, 
harsh and loud. 
The probe was passed several times into the windpipe, and past the broken shell without disco- 
vering it. It had been caught by the action of the transverse muscle, and the sharp broken edge 
forced into the mucous membrane ; which was the reason that it was not coughed out of the wound. 
