The influence of physical education in producing and confirming, in females, deformity of the spine
Duffin, Edward Wilson
'^:i fc - ■ ^ ^^^^■Bv^d ML f5- -k *, j^r^^^x I^^^HTr'VHlkL^ ^•^ S^ E^^IkvW i^^lBl ^ iiii'-'ilF<^^ ^P^ C* t^^\J\J J ^^^n^^^mw^^ t^4!ee.^-/f^^cl s£L^/^^d^/iu, Deposited by the BOSTON ATHENAEUM IN THE LIBRARY OF THE 25o3Ston Si^ciiical liBrarp SB^SiSociatiott, BY AUTHORITY OF THE TRUSTEES. Librarian. Digitized by the Internet Archive in 2011 with funding from Open Knowledge Commons and Harvard Medical School http://www.archive.org/details/influenceofphysiOOduff '>u. I ■ "f - - F ''~"M > - ..,.,„ A mi 1 : •;^ 1 ^/'" --D Jos-Vsny liiroo^. Jh7i^-d/i_y (/.Sallr/icmoUi/ THE INFLUENCE OF HYSICAL EDUCATION ^» •=*/»'■ ^^ PRODUCING AND CONFIRMING, ^^ IN FEMALES, DEFORMITY OF THE SPINE. BY E. W. DUFFIN, Surgeon. LONDON: GEORGE SWIRE, 38, NORFOLK STREET, STRAND. /> 1829. /Til GUNNBLL AND SHEARMAN, PRINTEUS, SAMSBURV SQUABB. EXPLANATION OF THE SKETCH. F, R, A plumb-line dropped from the centre of the groove, which lies along the nape of the neck, to shew the natural, perpendi- cular course of the spinal line. G, E. A line marking the deviation of the spinal line from the natural course, in this parti- cular case. G. Indicates the central or dorsal curvature of the spine. E. The lower, or lumbar curvature of the spine. I. The curvature in the neck. A, A. B, B. Lines drawn at right angles to F, R. A, A, indicates the prominence of the upper part of the right shoulder. B, B, indicates the altered position of the shoulder- blade, and the prominence of the lower angle of the same. This prominence IV EXPLANATION OF THE PLATE. constitutes the appearance, denominated " projecting"," " jutting*," or " growing- out," of the shoulder. C. The depression of the lower ribs of the left side. D. The corresponding projection of the lower ribs of the right side. PREFACE- The following observations, relat- ing to one of the most important inte- rests of society, are especially offered to the perusal of every person engaged in the superintendence of female edu- cation. Resulting from a careful and diligent investigation of the subject, they rest upon principles derived from a consi- deration of the structure, connexion, and uses of those parts of the human frame, to which they more immediately refer. b VI In the present day, when science is arrived at so high a state, when men in general possess so much of the in- formation formerly confined to a few, it may be unnecessary to insist, at length, on the utility and on the im- portance of Physical Education, or of " the application of the resources of knowledge to the preserving of health, and to the perfecting of the human form/' An inquiry into the various modes of Physical Education is, un- doubtedly, one of the most interest- ing pursuits that can engage the at- tention. Health, comfort, happiness, and even life, may depend upon ju- dicious conduct in those, to whose charge the first years of childhood are entrusted. To assert, that none of the views Vll presented in the following pages have ever occurred to former authors, would be dishonest. Many of them^ on the contrary, have been variously promul- gated in almost every age. Repetitions, indeed, of the views of others, must be employed in every work where utility is preferred to eifect, and where the humble office of instruction is more at heart than ambition for the fame of discovery. No essay, however, calcu- lated to present a general, and at the same time a popular, explanation of the subject is, as far as I am aware, at present in the hands of the public* As the subject is one of the utmost * Most works written expressly on Physical Educa- tion, treat more especially of the management of it dur- ing the period of infancy, or o the first five years of life only. vm importance to a very large portion of the community, and one, which every person of a well-infonned mind may investigate as well as the members of the medical profession, no apology is necessary for an attempt to reduce to a form intelligible to the general reader many valuable observations, which have hitherto been confined to writings, strictly professional. With the facts in general, which are so self-evident as to require little com- ment, most persons are, perhaps, already acquainted. Daily experience, how- ever, of the little practical attention that is paid to them, if it may be regarded as any criterion, leads us to imagine that they have hitherto wholly escaped the notice of the pub- lic. Most men know, from personal IX observation, that the deformity to be treated of in the following essay, is extremely common, and very correctly deem, that it is in a great measure to be attributed to some defect in modern education. What that defect is, or how it operates in producing the result with which every one is familiar, is not so generally known, yet is certainly well worthy of serious investigation. In these remarks, designed for gene- ral readers, technical terms are, as far as is consistent with accuracy, avoided, but, where general language fails in supplying their place, are ex- plained in a note at the bottom of the page in which they occur. The members of every profession employ a peculiar language, because the terms commonly in use are found insufficient X to indicate precisely, what is intended to be implied. Hence, terms which have been re- ceived into common use, in conse- quence of their application in medicine, will be much better understood than if translated by tedious sentences. In such instances, I hold myself at liberty to chuse between the generally received expression, and its parallel, in ordi- nary language, selecting that, which is best adapted to my immediate object — conviction. ] 7, Weyrnouth Street ^ Fortland Pface. ERRATA. Page 30, line 3, for of read for. 41, line 5, for an read the. 72, line 13, for is read are. THE INFLUENCE OP PHYSICAL EDUCATION m PRODUCING AND CONFIRMING DEFORMITY OF THE SPINE. Among the numerous deviations from perfect symmetry in the Human form, none is more frequent in occurrence or more deserving of serious consideration, than obhquity of the Spine. This defect presents itself under numerous varieties of form, some of which are not only painful to the sight, but a source of distress through life to the individual afflicted, and irre- mediable by the best directed efforts of medical skill. But the pain of the beholder originates in compassion for the helplessness and mental suf- fering which, persons ever so slightly deformed are known to feel when first presented in so- ciety. Sympathy, however, conveys but a feint B idea of the tormenting consciousness of physical inferiority which is perpetually haunting the thoughts of the objects themselves, — of many innocent and amiable persons, who to almost every other grace of the body add every ac- complishment of the mind, and, not unfre- quently, possess a vigour of understanding, that despises though it cannot overcome the paltry prejudice which converts a matter of mere ac- cident into a source of much mental inquie- tude, and sometimes even into a cause of se- clusion. The more highly the female mind is cultivated, the more intense must be its suffer- ing under this state of moral exile. For, inde- pendently of the numerous coarse and unbe- coming allusions to irregularities of shape in our scenic representations, and the much too frequent repetition of these in our Lyric poetry and Romance, the ignorance of the genteel vul- gar, and the occasionally intemperate rash de- clarations of medical men, have concurred in ascribing deviations of the most purely acci- dental kind, to the influence of certain con- stitutional maladies, the very names of which are never heard without abhorrence and dis- gust. Surely then he is engaged in the dis- charge of an important duty who endeavours to contribute something at least to alleviate the sorrows, and if possible, obviate the sufferings of many of the fairest portion of his kind. Cases of the nature last alluded to, either arising from disease, or connected with mal- conformation of some portion of the spinal column, are not so common as is generally ap- prehended. Fortunately the form under which the deviation most frequently presents itself, is not of a serious nature ; nor is it beyond the reach of surgical skill This form is technically denominated lateral curvature of the spine^ popularly permanent inclination of the back- hone^ either to the right or left side. This kind of deformity we learn, from an at- tentive perusal of the more ancient authors^ was by no means uncommon among females in the earlier ages ; while towards the close of the 16th century, it became so prevalent, that Pinaeus, who flourished about the year 1580, asserts " that of fifty females of the higher b2 (yr more civilized ranks of society^ scarcely two could he found who had not the right shoulder higher^ and more projecting than the lefty An assertion which but slightly mo- dified, may with considerable truth be applied to females of the higher and middle ranks of society, in the present day. The permanent inclination of the spine^ to either side, by no means necessarily depends, either upon original debility of constitution, or upon active and manifest disease, though its pro- duction or confirmation in persons of a scrofu- lous tendency, cannot be denied to be in some measure due to the somewhat soft, and imper- fect state which the bones are known occasion- ally to retain, in such individuals, even to a late period of life,* aided perhaps by an other- wise delicate physical conformation of the whole frame. In the absence of any such constitutional * In cases of this description, the bones do not acquire a sufficient degree of solidity to withstand unnatural pres- sure, or injurious muscular action, before the 16th or 18th year, or even later. debility, the primary causes of this deviation from the erect position, natural to the hu- man figure, are indisputably the result of ad- vancing civilization ; and may fairly be traced to sedentary and other erroneous habits, ac- quired most generally at fashionable semina- ries, or during a similar routine of education under the paternal roof — in fact to an injudi- cious system of school discipHne, to neglect or actual mismanagement of the physical education of young females, to the vitiated state of public taste, with respect to the perfection of female attire — and to many absurd customs and useless restraints of society, derived from the vain and ludicrous efforts of modern fashion to attain the very highest point of refinement. It has been the fashion with many to indulge in much rather unmeaning declama- tion, with respect to the mode of life adopted by teachers and parents for the education of female youth, and to speak of the rules they prescribe, as if they were the pure offspring of the whim, caprice, worldly-mindedness or ig- norance, of these natural superintendents of 6 an unprotected age. There is but little jus- tice in this insinuation, since, as may easily be shewn, they are themselves in point of fact not the leaders, but the led, not the constrainers, but the constrained. In the first place, it never has been much the fashion for young men to unite themselves with old or middle-aged women in any age or country ; and though our valiant und sagacious ances- tors, in the woods of Germany, forbade males to marry before the fortieth year,* yet it does not appear that their choice, on then emerging from celibacy, was confined, either by law or social practice, to ladies who had passed that period. On the contrary, we are told that they were in the custom of selecting their wives from among the young ; and that however much they venerated old ladies for their wis- dom, and prescience of future events, yet that this peculiarity of national character did not lead to any corresponding anomaly in their domestic affections or matrimonial engage- ments. Such then being the almost universal * Tacit. Germany. preference to youth, it follows that parents or guardians, who jiistly= — or otherwise — deem the state of marriage the most happy and natural in which a female can be placed, must be so- licitous to complete her education before that period of her life be passed, within which her chances of forming a suitable aUiance are chiefly confined. It appears, by the statistic registers of Paris, that by far the greater number of mar- ried women have become wives before the com- pletion of their twenty-fourth year, and that more women are married in their twenty-fourth, than in any other year of their age. If we now consider how many marriages take place, of the kind named prudential and which may be said to consume on an average from four to six years in their arrangement and preparation, compared with those resulting from love, or a sudden prospect of advantage, and concluded within a few days or weeks, we shall see that between the sixteenth and eighteenth year, about the period when a girl is in general fit to emerge from school, is by no means too early for her introduction into that world, of which her s chance of afterwards becoming a happy mem- ber, hes principally within such narrow Hmits. Nor is this all : — The ambition, for an ob- ject " that makes ambition virtue," of forming atn advantageous engagement, often animates alike the breast of father, mother, guardian, and child, and affords an additional motive for the early accomplishment of female youth, since, leaving out artifice and intrigue, which can have no place in honourable minds, and are never contemplated in the education of children, even by the unprincipled ; experience shows that desirable alliances are chiefly at- tainable through the early acquisition of female attractions. The only practicable improvement, then, which can be made in this early cultivation, is so to conduct its various steps, that the mind and the body may lose nothing of their native vigour. But how, it will be asked, is this great and truly desirable object to be obtained"? Abridge the study and increase the recrea- tion! This brings us insensibly to a second 9 cause of the deprecated evils in which parents or tutors have scarcely any other than a passive share. From the tremendous " march of intellect," and the vast diffusion of scientific knowledge, which distinguish the present age from the last, and the last from that before it, it is clear that the absolute quantity of information necessary to be acquired by young females, has " in- creased^ and is increasing ;" I will not venture to add, '' ought to he diminished ;'' whilst the time within which this is to be obtained, may be said to be, though indirectly, yet materially shortened^ in as much as the period allotted to school-study is, we have seen, from various moral causes, necessarily limited to a given age. Here then arises one of the most serious evils of the present system ; more is expected to be learned than ought to be reasonably re- quired of youth, or than can be performed wdth- in the limits assigned, consistently with health. But the study 'life of females is shortened fi'om numerous other causes. The hahit of eai^ly rising^ which distinguished our ancestors, 10 afforded the long and precious mwning hours^ which every true student knows how to value, and which lately have been well, though rather egotistically, recommended by that ingenious mercenary of politics, Mr. William Cobbett. A mind duly refreshed by sleep, and unoccupied by other cares, will for the most part make as much progress in one hour in the morning, as in two hours of the afterpart of the day : the study too proves less exhausting, and can therefore be longer continued with impunity. The study-life of females is also shortened by the increasing tenderness of mothers ; who, from the influence of fashion, luxury, and mental cultivation, have brought this feeling of maternal affection, which is steady and moderate in the natural and uncivilized state, to a degree of exaltation, which, besides being ludicrous, is altogether morbid, and frequently ends in the misery and ruin both of parent and child. All we have to do with it at present, is to remark, that from this very reprehensible cause, girls are often too late in being put to read, or they are taught by means of a governess living in the 11 family, and who would soon find her situation insupportable did she not comply with a mo- ther's modes and seasons of instruction, which are not in general very rigorous ; and it may be inferred, that the progress is seldom rapid, though the governess, not the system, bears the largest share of the blame. But a more common error, as will afterwards appear, is a premature direction of the infant mind to study before the evolution of the judging and reflect- ing powers. The study-life of a young lady is also shortened by the minute attention to fashion, which distinguishes modern females ; and this extends equally to the modes even of eating and moving — as to the adjustment of their ap- parel. Formerly, all these items, if not abso- lutely fixed, did not vary much in the course of a century or reign ; but evanescent and com- pHcated as they are at present, they must ne- cessarily consume a great part of that staple of existence — ^Time. Lastly, much time is unnecessarily taken up in female seminaries, in unskilful attempts to 12 prevent) and efforts, generally unavailing, to correct deformities of the person. Days and weeks are expended in this manner, and it may be said needlessly; since were the system of physical discipline founded on a different prin- ciple, there would be no necessity to anticipate any evil, and cases would but rarely present themselves requiring correction by any but natural means. Moreover, there are resulting from the pre- sent state of society, several powerful causes that produce a remarkable influence on the modes of modern instruction, and which, by over exerting the mind, and abridging the time allotted to recreation, tend materially to favour the formation of diseases of the spine. The first of these is the immense competi- tion which is to be met in every line of em- ployment, and in none more universally than in that which embraces the superintendence of female education. The necessitous in every relation of life, the daughter, the widow, the mother ; and of these the number is continu- ally being multiplied by the increasing taste 13 for pleasure or luxury : all endeavour to re- lieve their wants, or to raise their fortunes, by a draught on this common fund, the education of children. Now admitting, what is very questionable, that all these competitors for public favour, if not capable of undertaking the immediate or practical part of instruction, are sufficiently ac- quainted with the principles of education to superintend the studies of youth, it does not follow that they are at all versed in those of physical discipline. In truth comparatively few who undertake the early instruction of females know anything of the principles of physical education; there is a beaten course which, it may be said, they mechanically pursue, without ever once thinking of investigating its ulti- mate influence on the natural operations of the delicate and irritable parts which compose our system. Indeed, they are unacquainted with the mode of instituting such inquiry ; it is the province of the physiologist ; all they can un- derstand is the present apparent good. It is not by these hints intended to convey any cen- 14 sure on the ignorance of teachers and superin- tendents in this respect, because not only is the subject one of acknowledged difficulty to all those who have ever troubled themselves to investigate it, but it is one that the general course of the preparatory studies of even those designedly educated for teachers does not lead them to inquire into. Moreover, if there are, as in other profes- sions, a sufficient number of persons expressly trained for the office of instruction, it is clear that the above immense irregular additions to this number, will have the effect of producing an unusual degree of competition. Of this the immediate result must be, attempts to excel each other, and a laudable emulation to ob- tain their common object, public confidence, wealth, and consequence. This may give rise to a positive improvement in the art of teaching, but it will be, in general, at the expense of the physical development of the taught. The improvement reaches, as was in- tended, the ears of parents and guardians ; they hear, and often in an exaggerated form, of the 15 progress made by the pupils at a particular school, and naturally decide upon availing themselves of the abilities of so eminent a teacher in the case of their own children. It is by a reputation of this kind that all our fashionable boarding-schools are filled : recom- mendation does the whole ; and as the presence of a few noble children in a seminary of this class will go farther to extend that reputation than the praise of ten times as many com- moners, it is clear that ideas oi fashion and fashionahle conneocion also mix themselves with those of utility in the minds of the guar- dians of youth. In short, the English non- descript idea of respectability includes all these, and, possibly, something of the good principles of the teacher in addition. But before entering his child at such an institution, the parent ought to ask himself how, and at what cost all this superiority is acquired '? Is it by adopting more natu- ral systems of the individual arts and sciences they teach, so that the memory is neither wea- ried nor disgusted'? Or is the succession of 16 the whole of these sciences so adapted, piece by piece, each one to the other, that the scholar finds everywhere something that is past, with which she may connect the something new that follows"? Or are there arrangements made in these establishments to obviate the several causes which, in modern times, as we have seen, tend actually to shorten the legitimate period of study"? Or, lastly, does the per- son any where exist so well acquainted with the powers of the human understanding, and the passions of the human heart, as to be able, through them, to wield at will, to excite or fix at pleasure, the attention of the human mind ? Let him depend upon it, if he fails in obtaining an affirmative answer to these questions, that the method pursued here, how- ever sophisticated by pretence or innocent ig- norance, produces extraordinary improvement only by employing extraordinary hours : that is to say, by extraordinary extension of the time of study, and consequently by extraordinary in- vasion of the period of recreation. In the Esta- bUshments named Finishing schools, their sub- IT jects are usually grown-up girls, who come there in health, and are expected to remain but for a short time. The discipline is there- fore more rigid, the invasion on the time allotted to recreation is greater, and as is proved by experience, at this period the great- est mischief is frequently done to the form of the body. Unfortunately the conductors of elementary schools, taking into considera- tion only the advantages to be gained by the compendious system pursued in the finish- ing establishments, are every day approaching more and more to the intense exertion re- quired by that system. Another powerful cause which leads to this premature severity in education, is the ge- neral advancement of knowledge. Many girls, long before the period at which they are sent to school, betray all the curiosity and acuteness characteristic of the sex; and from the conversation of those around them, frequently acquire a considerable share of knowledge before they leave the paternal roof. These facilities of acquiring information are in a great measure due to the very attrac- 19 tive form of many of our *' juvenile publi- cations." By the aid of fable, narrative, and the productions of the graphic art, a young lady of the present day often enters the seminary with more information in her head, than oc- cupied that of her grandmother upon leaving it. But this superiority of acquirement only leads to the imposition of harder duty in the school-room ! Mrs. A . has seen and admired the v^onderful progress of Miss B. at a school examination, and without ever stopping to ask the questions propounded above, or even whe- ther this young lady may not be simply an in- stance of precocity, makes every exertion in her power to render her own daughter a rival, at least, to the object of her admiration. He is either very charitable or very simple who is not fully persuaded that rivalry of this kind exists ; nor does he require any great study of the hu- man frame to enable him to comprehend that much incurable mischief is often occasioned by these well intended, but injudiciously directed efforts at the attainment of an imaginary excel- lence. To praise a young lady for being highly c 2 20 accomplished, is often enough to make a whole bench of matrons glow with emulation. How- ever much akin to envy, it would be cruel to censure this passion, the principle of which is honourable and just. Enough that it is a pas- sion^ and that when predominant, it often proves injurious to the delicate female, beyond even the worst wishes of an invidious rival. Still it must be remembered, that this rivalry of parents and guardians, like that of teachers, has its origin from without. Whilst the heart and passions of man continue the same, the same effects may be expected to spring from similar causes. Till the eyes of parents are opened to the evils finally resulting from ex- cessive competition, it is neither rational to ex- pect that these evils will cease, nor just to insi- nuate culpability in those who are but yielding to the deductions of their own understanding, and the influence of some of the best principles of human nature. Hitherto my observations apply to a depart- ment of education, regarding the principles of which, and the practice founded upon them, the 21 opinions of mankind are continually fluctuating. They are now to be directed to the investiga- tion of a subject on which my readers may fairly be considered to be less open to conviction. An attack openly made upon existing pre- judices of the worst kind, those which flow from long continued and favourite customs, sanctioned and supported in the female mind by a firm belief in the valuable aid they impart to the graces of nature, can scarcely be made without exciting against its author some de- gree of distrust, and may, perhaps, expose him to the ridicule or contempt of the unreflecting and the ignorant, but will, he is confident, meet with support from the more serious and better informed portion of his readers. The present, however, is by no means the first effort that has been made by professional writers to direct attention to this interesting subject, and to stem the tide of popular error. As early as the year 1550, we find medical men engaged in investigating the nature, causes, and best means of preventing this deformity, and in pointing out the simple attentions by which it 22 may be removed, and the necessary precautions against its return. Nor is it difficult, when the female costume of that period is taken into con- sideration, to find satisfactory reasons for the advice there given: — *'the discontinuance of corsets and other bandages calculated to dis- figure the human frame." * From the gradual and insidious manner in which any deviation from the natural position of the spine takes place, the evil may attract little or no notice, until such time as it has pro- duced confirmed deformity. When the at- tention of parents is roused, the most injudi- cious treatment, founded on a mistaken view of the nature of the malady, is not unfrequently adopted. The remedy indeed is sought in an accumulation and more rigorous observance of the very practices whence the evil originates, in the imposition on the part of the governess and dancing-master of additional restraints to be enforced by the application of such m«i chines, as bandages, unyielding corsets, back-boards, and perpendicular -backed chairs. * Knox's Prob. Essay, p. 7. 23 A particular detail of the evidences of a de- formity with which almost every one is famiUar, is perhaps unnecessary. There are few mothers or teachers who have not seen the "jutting shoulder." The child arrived at the tenth or twelfth year, perhaps at an eariier period, has already spent a twelvemonth or more at some private seminary, or has been placed under the especial superintendence of a governess living in the family, whose sedulous attention to the personal appearance and carriage of her pupil is remarkable; yet, in spite of the exertions of the governess or school-mistress, it is observed that the child is becoming crooked. The right shoulder projects more than is natural, and is, in common parlance, said to be "growing out." The course of the central groove* of the back deviates from a straight line, a greater distance is observed be- tween a given point of the original perpendi- cular spinal hue and the top of the elevated * Some of the vertebrse of the back are situated be- tween the blade-banes, and when the form is natural, fail gracefully inwards at this point, forming a groove. 24 shoulder-bone, than between the same point and the corresponding top of that of the left side. These appearances, together with a re- markable prominence of the lower-third of the shoulder-blade of the distorted side, alarm the parents, now surprised at the extent to which the deformity has proceeded without having attracted much notice. The gait of the young person appears awkward and shuffling ; her clothes cannot be made to sit well upon her — they appear to be drawn to the right side. The sash encirchng her waist is observed to dip towards the same side, while the right breast presents a remark- able fulness,* and the corresponding collar- bone displays a proportionate elevation. •]■ * When the deformity is not noticed till about the fif- teenth year, the state of the breasts most frequently first attracts attention, one appearing larger than the other, and growing so unequally as to lead to a suspicion that it is diseased. — Shaw on Deformity, f The symptoms in the text are those which denote inclination of the spine to the right side. But it may be observed, that the obliquity does not, as the epithet lateral would imply, iavari'^bly take place to the side ; this is 25 In short she is crooked ; her back-bone is distorted. In a multitude of instances, even in this early and remediable stage, absolute and permanent deformity can be prevented only by care and attention of no ordinary kind, di- rected upon principles derived from a thorough knowledge of the nature of the parts affected. In proportion as the inclination takes place in the upper part of the back between the shoul- ders, nature, in order to counterbalance the evil, and preserve the equilibrium of the body, calls into action the muscles of the lower part of the spine ; these operate with proportionate power on the opposite side, so that, in confirmed cases, there is in fact a double curvature pro- duced, as exemplified in the lithographic sketch facing the title-page.* only the most frequent direction it assumes. The spine may- form an incurvation from behind forwards, or an excur^ vation in the contrary direction, and sometimes these varieties are complicated with each other. — Banifield on the Spine. * The sketch is intended to illustrate the mode of ascertaining by measurement the extent of the deviation in examples of lateral deformity, and will enable any one 26 As the distortion advances, a similar coun- terbalancing power is exerted by the muscles attached to the spine in the neck, and a third, or upper curve is then formed, so that the spine presents, in fact, a serpentine appear- ance, inclining to each side alternately. The ribs, in consequence of the alteration in the course of the spine, deviating from their true direction, partake of the change instituted. Finally, the basis, or pelvis^ on which the spine rests becoming involved, produces an inequa- lity in the size of the hips, the contrary of that which presents itself in the shoulders, and causes the v/hole body, when viewed from behind, to appear as if twisted on itself. (Vide sketch.) When the deformity is really ascertained to exist, there is every reason to suppose that the system of school discipline the child may be pursuing, is erroneous. The parents should to submit a doubtful case to this most accurate of all tests. When, however, the deformity arises from other causes, as from malformation of the pelvis or base on which the spine rests, the mode of measurement delineated will not detect the full extent of the evil. 27 immediately take alarm, and a different system, founded on more scientific principles, should be adopted. Let it not be argued that the girl will " out- grow the deformity;" She never will. This, though a common, is a very erroneous and dangerous notion : the parent who rests his hopes on so fallacious a foundation must ul- timately be disappointed. The longer the de- formity exists, the more conspicuous it is sure to become. When estabhshed to any considerable ex- tent,, artificial means, however well applied, aided even by the best devices of the milliner, fail in conceahng the deformity. During child- hood—backboards^ unyielding stays, constrain- ed positions, concealed pressure,* and similar means, are employed with a view to "force in the projecting shoulder," erroneously said to be " growing out ;" a mode of proceeding al- most invariably productive of injury to the * It is a prevailing custom to bind over the projecting shoulder a piece of lead, which is concealed under the dress. 28 form of the chest, for it is only at the expense of the just configuration of this important part of the system that such means can exert even an apparent influence in remedying the evil. The real origin of the injury not being sus- pected, a judicious mode of effecting its re- moval is scarcely ever employed. At a later period of hfe, mechanical means, being found ineffectual in restraining the progress of the mischief, are abandoned. Such distortions are observed to be by no means uncom- mon;, and, like other evils in common occur- rence, are supposed to be irremediable, and considered of comparatively small importance, particularly as they neither incapacitate the person for the fulfilment of the ordinary duties of life, nor appear to affect the probable dura- tion of existence. Artifices of dress are now substituted for mechanical contrivances, and the manipulations of the waiting-maid supply the place of surgical skill ; or in more pointed cases, the machinist is resorted to, who not un- frequently aggravates the mischief he promises to cure. 29 In some cases indeed, the eye of the ordinary observer may readily be deceived by the arts of modern dress-makers, as well as by various mechanical contrivances, but rarely that of the anatomist or artist, however skilful or judicious may be the mode of applying them. Nay, even when these arts are most successful, the shuffling gait — the ungraceful motion of the feet — the unsteady carriage — at once enable the observer to detect the existence of an evil which, arti- fice apart, may by the aid of measurement be rendered apparent to the most superficial ob- server. (See engraving,) To give the general reader any just compre- hension of the manner in which the fashions and customs pointed out (page 5,) are influ- ential in giving rise to, and in confirming, the deformity we are considering, will be a difficult task, unless he be first put in possession of some general knowledge regarding the struc- ture of the flexible column of bones, popu- larly known by the name of the '•'•hack-hone;' and of the means which nature appears to have ^0 provided for preserving the symmetry and up- right direction of this column, and at the same time of rendering it applicable to the various purposes of life. Possessed of this informa- tion, he will be prepared to understand and to appreciate how far her intentions are baffled or subverted by the agents in question. The column of the back consists of a pile of small bones, technically denominated vertelrce^ twenty-four in number, placed one above an- other in succession, so as to form a bony pillar finally surmounted by the head, which may be considered its capital. These small bones are connected together by the apposition of certain processes, (for it is thus anatomists name the smooth and po- lished projections,* growing from bones) main- tained continually in their relative position, and in contact, by means of small bundles of strong white elastic fibres f attached firmly to the margins of the processes in every two bones so connected together. By the skilful * Technically, articulating processes. f Technically, ligaments. 31 disposition of these polished projections, pro- vision is made for allowing the column to be bent in almost every direction, as the wishes or necessities of the individual may require. Through the centre of this column runs a somewhat trilateral tube, for the purpose of containing the marrow of the backbone;* and on its summit rests the head, usually in an adult from seven to ten pounds troyj* in weight. A plane dividing the crown of the head, in the direction from before backwards, and continued vertically to the ground, when the individual is standing erect and looking straight forward, in the natural state, divides the back-bone into two halves. The spine, there- fore, in relation to the plane on which the per- son stands, and which intersects at right angles the dividing plane may be said to be ver- tical^ although it is also naturally curved an- teriorly and posteriorly. The vertical position is maintained, while the column itself is enabled to bear the weight of the head without yield- * Spinal marrow, or spinal chord. f The brain alone is four pounds, the cranium three pounds. 32 iiig under the burthen, and also, after perform- ing all its various inflexions, to regain the ver- tical position by means of two very considerable masses or cushions of muscles,* placed one on each side of it, and attached to various projec- tions from the individual bones. So admirably are these muscles arranged, that when left to nature, and uninjured by vitiated habits, they have the effect of exerting such a balancing power over every separate bone upon that placed immediately beneath it, as to keep the whole pile of bones not only at rest, but abso- lutely upright in regard to their lateral aspect. Now it is a law of the animal economy, that whenever the natural and healthy operations of any organ or set of organs, are either not regu- larly, or not sufficiently exercised, the organs whose operations are so disturbed or omitted, suffer material injury in a proportionate loss of their capabilities of action. In some instances indeed the derangement so produced gives rise to active disease. * Muscles may be defined, bundles of fleshy fibres, capable of contracting by the exertion of the will. 33 Again, organs, when they are too much ex- erted, or when their natural operations are kept up beyond certain Hmits, become fatigued and incapacitated for the performance of their wonted office, until by repose they are enabled to obtain a renewal of their exhausted nervous, or vital energy. From a careful consideration of these two principles, the mode in which the circumstances, already enumerated, prove influential in giving a tendency to, or in permanently confirming inclination of the back-bone, may be easily gathered. They interrupt, or wholly prevent the operation of one class of muscles attached to the bony column of the back, and they exert unnaturally, in an injurious and protracted action, the operations of a second class ; the effects resulting fi'om which irregularities may be traced in the following observations. The uses of the two layers of muscles ranged on either side of the back-bone, as has al- ready been stated, are to keep that column vertical or erect, ^. e. upright from the ground, (in relation to its lateral aspect,) when the 34 person is at rest, and moreover, to enable it to be bent at will in any requisite direction within given limits, and to secure its return to the previous vertical position. In order to provide for the due performance of these opera- tions, it has been explained, that these muscles exert a kind of balancing power on each indi- vidual bone, so as to keep it properly poised upon the one immediately beneath it. It is evident then, that the free and unimpaired action of every individual muscle is neces- sary to the absolute integrity of the vertical state of the column. 