78 DISEASES CLASS 1. 2. 2. 18. 



In this case there is no expectation of recovering the straight- 

 ness of the end of the bone; but these patients are liable to 

 another misfortune, that is, to acquire afterwards a distor- 

 tion of the spine; for as one leg is shorter than the other, they 

 sink on that side, and in consequence bend the upper part of 

 their bodies, as their shoulders, the contrary way, *o balance 

 themselves; and then again the neck is bent back again towards 

 the lame side, to preserve the head perpendicular; and thus the 

 figure becomes quite distorted like the letter S, owing originally 

 to the deficiency of the length of one limb. The only way to 

 prevent this curvature of the spine is for the child to wear a 

 high-heeled shoe or patte on the lame foot, so as to support that 

 side on the same level with the other, and thus to prevent a 

 greater deformity. 



I have this day seen a young lady about twelve, who does not 

 limp or waddle in walking; but nevertheless, when she stands 

 or sits, she sinks down towards her right side, and turns out that 

 toe more than the other. Hence, both as she sits and stands, 

 she bends her body to the right; whence her head would hang 

 a little over her right shoulder; but to replace this perpendicu- 

 larly, she lifts up her left shoulder and contracts the mtiscies on 

 that side of the neck; which are therefore become thicker and 

 stronger by their .continued action; but there is not yet any very 

 perceptible distortion of the spine. 



As her right toe is turned outward rather more than natural, 

 this shews the disease to be in the hip-joint; because, when the 

 limb is stretched out, the toe cannot turn horizontally in the 

 least without moving the end of the thigh-bone; although when 

 the knee is bent, the toe can be turned through one-third or half 

 of a circle by the rotation of the tibia and fibula of ihe leg round 

 each other. Hence if children are set in stocks with their heels- 

 touching each other as they sit, and are then made to rise up, till 

 they stand erect, the socket or head of the thigh-bone becomes 

 injured, especially in those children, whose bones are soft; and 

 a shortness of that limb succeeds either by the bending of the 

 neck of the thigh-bone, or by its getting out of the acetabulum; 

 and a consequent rising of one shoulder, and a curvature of the 

 spine are produced from so distant a cause. 



M. M. An elastic cushion made of curled hair, should be 

 placed under the affected hip, whenever she sits; or should be fit- 

 ted to the part by means of drawers, so that she could not avoid 

 sitting on it. A neck-swing and lying down in the day, should 

 be occasionally used to prevent or remove any curvature of the 

 .spine. The rest as in Species 13 and 15 of this genus. 



18, Spina protuberant- Protuberant spine. One of the bones 



