PAPERS ON MEDICINE AND PUBLIC HEALTH 307 



doiuinal strain of modern civilization. It may also be 

 considered an indication of man's imperfect adaptation 

 to the erect position. 



Chronic constipation, faulty posture, lack of exercise 

 and improper clothes, with the resulting flabby abdominal 

 musculature and sudden strain, are factors in its produc- 

 tion. Hernia, to a considerable degree, is preventable. 

 Its presence in young adults is proof of neglected sur- 

 gery. 



SPINAL CURVATURE 



While heredity may produce conditions favorable to 

 the development of curvature of the spine, faulty posture 

 is the most frequent cause. Abnormalities of the spine 

 are more common among girls than boys, due, to a large 

 degree, to the differences of dress and the manner of 

 living. Curvature of the spine is part of the price paid 

 by man for the ability to stand erect. The force of 

 gravity is both a predisposing and an exciting cause. 

 Curvature may be secondary to disease and deformity, 

 both of the spine and of other parts of the body. 



As only a very small per cent of the cases under con- 

 sideration are structural in origin, we wish to call atten- 

 tion to them, particularly, as defects of carriage and 

 posture. Happily, the great majority of abnormalities 

 are correctible by physical training and individual atten- 

 tion. Only about 10'< of the women and 7% of the men 

 show anatomical abnormalities of the spine that are 

 correctible by gymnastics with difficulty, if at all. 



There has been a slight tendency to increase in curva- 

 ture of the spine among high school graduates during 

 the last four years. This rise, we believe, to a consider- 

 able degree is explainable by more careful record of 

 slight deviations from normal. Many of these postural 

 deformities might be described as a slouch or sag and 

 are correctible by the individual himself when his atten- 

 tion is called to it. As his musculature is weak, he needs 

 exercise, otherwise he will resume his old position as soon 

 as his attention is diverted. 



In the comparison of the relative frequency of lateral 

 curvature, stooped shoulders, and swayback, scoliosis 



