Page:Popular Science Monthly Volume 22.djvu/337

Rh family doctor—and the sang-froid of the general practitioner who meets the difficulties by the administration of a few doses of steel and quinine and rest in the recumbent position?

No deformity of a child's body gives rise to so much alarm to parents, or is the subject of greater diversity of treatment among medical men, as lateral curvature of the spine, and this is due, I believe, to an imperfect acquaintance with its origin. Specialists are accustomed to treat lateral curvature, knock-knee, and flat-foot as distinct deformities, while in truth they are all links in the chain of one deformity. Lateral curvature may arise in different ways, but in all cases it is due to the loss of the lateral balance of the body in the upright position, and is the result of an effort of nature to maintain the center of gravity of the body and support the head and shoulders in the position which requires the least expenditure of muscular effort. The paralysis, wasting or loss of a limb, or the shortening of one of the legs by disease of joint, rickets, knock-knee, or flat-foot in growing children, will produce lateral curvature, and these are its chief if not its only causes. It is not a deformity arising from general debility, and I do not think it can be produced, as is often asserted, by an awkward sitting position, as in writing and other school occupations. The curvature of the spine which results from these causes is antero—posterior, or what is commonly called round-shoulder (non-carious). The tendency of debility, whether local or general, is to bring the body into the prone or recumbent position, and not to tilt it on one side.

Setting aside the cases of lateral curvature in children who have been affected with rickets, disease of joints, paralysis or loss of a limb in early life, and which affect both sexes and all ages equally, what may be called the idiopathic or acquired deformity is rarely found in children of either sex under the age of nine or ten years, and very rarely in boys above that age. It is, indeed, almost peculiar to girls verging on puberty, and is as often found in strong and healthy as in weak and delicately built girls, and most commonly in those who are too fat and heavy for their stature and age. It is a deformity which is less common among the laboring classes than among the rich and well-to-do, and is largely associated with a life of indolence and luxury.

A careful examination of the subject has satisfied me that this acquired lateral curvature in girls is due to the change in the position of the lower limbs, resulting from the development of the pelvis from the infantile to the female type a year or two before the accession of puberty. Any one who will examine the figures of young children below this age will find little differences between the two sexes. The legs of young girls are set on the body like those of boys, and, within the limits of their training and dress, they can run as well and as gracefully as boys; but as puberty approaches, and the pelvis alters