The morning news. [volume] (Savannah, Ga.) 1887-1900, 1892-02-17

/ tlOn, pulling the sOftene0 bones out OF the
vertical line, bOwing them forward or out
ward, sometimes even backward. as the
cass may be.
ricketts, is not the only cause Of bow legs
among children, although il is the most
common one. IL is probable that children
who have never had rickets may acquire
bow legs il foolishly permitted to stand in
earliest infancy, although. as already said,
this is not the most common cause Of the
| affection. Affections of the spine and hip,
which throw the body out of its Normal
perpendicular, may be instrumental in in
ducing curvature Of the lower limbs, the
direction OF which will depend upon the 10
cation of the original disease.
Lateral curvature OF the spine is zone
sided" deformity, which may or may not be
due 10 ricketts,. More commonly no history
Of this disease can be obtained, nor, indeed,
is it always possible to obtain a history OF
any cause for the occurrence of this deform-
ity in many cases. Rickets occurs most
commonly between the ages Of early infancy
and years. while lateral curvature seldom
makes its appearance before the age Of TO-
although the writer recalls several mild
cases occurring in little girls as early as Z
years of age.
Authorities differ as to the most common
period for the appearance of this affection,
but the years between and Is may be ac-
cepted as fairly approximating the truth
for the greatest number of cases. Lateral
curvature is understood to be the elevation
OF the spine from its normal vertical axis.
with more or less twisting Of the bodies Of
the vertebral column, which twisting or
turning is called rotation. There have been
many theories advanced to account for this
deformtty, which is one OF the most fire.
Quent among growing children. As it Is not
a disease OF the bones, the expla-
nation Of disease in the body anywhere is
not a sufficient one. Some observers have
considered IL to be due solely to weakness of
the muscles upon one side OF the body, per-
hitting the deviation of the spine to that
side. But this explanation does not seem
to cover all cases, because we find curva-
lures occasionally where no difference of
the strength Of the muscles on either side of
the spinal column can be discovered, and
also in cases where the muscular system APP
pears to be in excellent tone and
vigor. Other observers claim than the
lateral curvature is due to faulty
attitudes and one-sided positions
which the children assume either in their
school occupations or while carrying heavy
weights upon one side Of the body, or even
in the onersided position necessitated by
horseback riding, while others have sug-
gested that these one-soed positions are
only the result OF an unsymmetrical de-
velopment of the bones of the spinal column
itself, which, being thus unsymmetrically
developed and larger upon one side than the
other, necessarily throw the trunk into an
abnormal condition.
None of these theories or others which
have been advanced appears to be entirely
satisfactory, aud in many cases we cannot
find any sufficient explanation for this con-
dition. A safe practical working theory
for the majority OF these cases, however,
will be fouud in that which holds the cause
OF this deformity TO lie in the superincum.
bent weight Of a child's head aud trunk,
pressing upon structure whose supports
thgaments and muscles) are weakened
through general debility, the kind and de-
gree Of the curvature being generally de-
termined by the faulty positions taken at
the school desk or everywhere.
THE growing out of one shoulder" or a
prominent nip, which are very common
among children, are generally the signs of
a lateral curvature, and are always its &C.
compartments to a greater or less degree.
1t is commonly the discovery of one or both
OF these affections that first calls the atten-
ton of the mother to this tendency in her
child, and brings her to the doctor for an
explanation.
We have already mentioned tuberculosis
as one OF the diseases which is more or less
directly causative of deformities in chill
dren. The deformities which are caused by
this disease are commonly those which re-
suit from affections of the joints, such as
the hip joint, the knee, the ankle, and nota-
bly, the spinal vertebrae. So commonly is
this disease discovered among children, that
1t is believed by some observers that
Tuberculosis is the remote cause of practi-
cally all Of these joint diseases, initiated
often by some accident, such as a fall or a
blow. This may be an extreme view, but
there can be no doubt Of the immense in-
huence Of tuberculosis as a causative agent
In such affections, while as regards the
effect OF accidents upon their production, it
has proved that blow or fall will start
up these joint affections in an animal
already tuberculous, while the same vio-
leDce will fail to produce them in one that
is healthy.
External violence and the accidents COM
mon TO childhood, such as fall on one hin
or down staircase, are in themselves more
liable to induce disease in children, because
the portions of the bones here affected are
at this period in their most active state of
development, many and varied changes
continually going on which require the best
OF conditions for their permanent adjust
ment. If these are suddenly disturbed by
violence of any kind the bones are liable to
feel the injurious influence, from the fact
that children are less easily kept quiet, and
SO tend t6maintain the excitement of part
when once it is inaugurated.
The deformity which results from dis
ease of the bones of the spine is known as
Potts disease, and results in an angular
mot lateraD curvature of the spine very
different from the other variety we have
already alluded to. AS the bodies of the
vertebrR are softened by this disease, they
give way, and the result is fitting forward
OF the part of the spine above tho disease,
with certain amount of backward angular
deformity at the point of disease. The re-
suit is the prominence or knuckle in the
back, which is to the laity the sign of this
agection. producing in severe cases the con-
dition known as "humpback. The history
Of these children often points to a tuber-
cular origin, but the disease and defor nifty
also occur where no other cause than trau.
matism Of some kind can be assigned.
A glance over the general subject OF de-
formities. painful as it is in many respects,
is not without encouragement when we
note how many of them are due to more or
less preventable causes. Ricketts,, while it
is often insidious in its progress, is in q gen.
eral sense, a preventable disease, to be
warded OFF by intelligent care regarding the
diet and general hygiene of the child and
medical advice when any suspicious disturb
ance arises.
tuberculosis is also now regarded as in
great measure a preventable disease, and
there is no question that better general
hygiene oflchildren and greater precautions
regarding the source of the milk which they
drink, or where that Is impossible, the ster>
ilization OF it when purchased in cities,
would limit the spread of this dread disease.
The lesser deformities which are due to