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Report of the Medical Officer (Education).
147
The total numbers examined were not sufficient to give an accurate percentage, but it is clear
that the number of cases of curvature found was considerably lower than that usually recorded
amongst school children. This may mean that the children in these secondary schools have straighter
backs than those examined by other recorders, but it is more likely that it is due to a difference of
standard. This is rendered specially probable by the large number of comparatively slight cases of curvature found.
The cases were classified into the following varieties:-
Girls.
Boys.
Totals.
Kyphosis
10
1
11
Kypho-lordosis
3
1
4
Lateral curve—
Single to Left
31
8
39
Single to Right
6
13
19
Double R. Dorsal L. lumbar
9
5
14
Double other varieties
3
2
5
With the exceptions of three boys and six girls all the children showed comparatively slight
deformities easily corrected by regulation of posture, and nearly all came into four classes—
1. Kyphosis.
2. Single curves to left.
3. Single curves to right
4. Double curves, right dorsal, left lumbar.
The first three of these classes constitute the common varieties of school postural curves and
deserve a little further consideration.
Kyphosis.—By this is meant an excess of the normal backward dorsal convexity. This convexity
varies a great deal in different individuals ; it is often comparatively great in those of unusual
muscular power. To lay down an absolute standard is therefore impossible. It may be considered,
however, that a child is kyphotic if with a strong dorsal curve the head is poked forward, the chest
flat, the abdomen prominent and the scapulae placed further forward than natural on the chest wall.
These children, if told to hold themselves up are apt to correct the kyphosis by strongly arching the
lumbar spine throwing the shoulders back but leaving the chest as flat as ever and making the
abdomen more prominent. If this mode of correction goes on throughout the period of growth the dorsal
convexity becomes fixed, a definite lumbar lordosis arises and the condition changes into the more
unsightly and less treatable kypho-lordosis. If proper postures are taught in the early stages kyphosis
in children is, however, easily cured.
Kyphotic Child showing—Ordinary, Over-corrected and Correct Attitudes.
Single curves to left.—This is the commonest variety of school curve. Scholder found that 70
per cent. of curvatures in the children he examined belonged to this class. In the present series
just 50 per cent. of the lateral curvatures were left sigle curves. In 20 out of the 39 cases there was
an associated kyphosis. The usual appearance of the child with a left single curve is that in
addition to his kyphosis the whole spine tilts in a long curve to the left, the right hip being thus
rendered more prominent and the left shoulder raised. This posture is a common one in many users
of the right hand below the shoulder level. It is one of the common postures of the spine in writing.
These cases are easilv corrected and in fact probably often correct themselves during growth, for this
long curve to the left is not commonly seen among adults.