Cervical Ribfi in Mun. 103 



impressions on the hard inner tables of the chivariiun. The reason 

 that eerviral ribs appear to stranf^ulate the blood supply of the limbs 

 is that from the involuted lin)bs no impulses arise to )iut into the 

 heart and arterj' enouofh force to drive blood in <j:reater (juantity to 

 the involuted limbs than their atnvphic state demands. If the develop- 

 ment of cervical ribs occurred with bi<i^ and vigorous pectoral limbs, 

 there would be force enough in the artery to <rroove the ribs and to 

 accommodate itself so that the blood supply would be unimpeded. 



Tbe treatment of cervical rib is confronted by greater difficulties 

 than a piece of bone : cervical rib is but the index of an undesirable 

 evolutionary condition which Oppenheim calls '' stigmata of degenera- 

 tion." Some of the results of the abandonment of quadrupedal pro- 

 gression are : — 



(1) Weak upper limbs. 



(2) Atrophy of the neck. 

 (.■}) Ck)stal breathing. 



{i) Migrated lung. 



(5) Depressed heart. 



(6) Liability to brain injury through curtailment of neck 



mobility. 

 The practical side of the subject of cervical ribs divides itself into 

 two sections : — 



(1) Tlie treatment of those suffering from the conditions that are 

 associated with neck ribs. (This is work belonging to 

 experienced surgeons.) 

 {'1) The physical training of the huuum body so that the exist- 

 ing occasional tendency to develop cervical ribs may be 

 turned into a tendency to remain true to normal neck- 

 type. 

 Tlie crawling period of infancy is probably the groat factor keeping 

 the lunnan neck, arms and thorax true, or a{)pi-oxinuitely true, to 

 mammalian type; therefore games of a quadrupedal nature are bene- 

 ficial to children. Growing children should l)e examined periodically 

 for the detection of any tendency to lateral curvature of the spine. 

 Exercises for the development of the great serrated muscles should 

 during the period of growth and development, be taken daily. During 

 childhood, adolescence and adult life, diaphragmatic breathing should 

 be regularly practised. Adults starting to take exercises should 

 remember that there are two types of neck, (1) the normal or mam- 

 malian ; (2) the aberrant type in which cervical ribs occur. 



Tlie exercises that have been'advocated are of the nature of a return 

 to natural function which the erect position has thrown out of use. 

 It should bo clearly borne in mind that those adults who have cervical 

 ribs are likely to cause themselves pain by doing quadrupedal exer- 

 cises, as their evolved tissues are ill-fitted for such w-ork. 



