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148
Annual Re-port of the London County Council, 1910
Single curves to right.—These are not uncommon in school children ; they were specially numerous
in this series amongst the boys. The curvature is rather different from the left single curve. The curve
to the right is slight and is situated high up in the dorsal region, the scapula on the right is raised out of
proportion to the spinal curvature. There being no curvature in the lumbar region neither hip is
unduly prominent. This elevation of the right scapula is another common writing attitude. These
cases in school are nearly all very slight and easily corrected by regulation of posture.
Double Curves.—The double curves with the exception of those already mentioned, were all
very slight, in fact they scarcely required treatment, but inasmuch as it is these double curves which
develop occasionally into the really bad forms of scoliosis it is important that they should be noted
and the children who suffer from them kept under observation. In all varieties of lateral curvature
slight rotation of the vertebral bodies towards the convex side of the curve occurs. Severe rotation
only occurs, however, in the double curves and is the exception in school curves ;such rotation was only
detectable in one case besides those already described as severe curvatures. In a hospital exercise
clinic a large majority of the children or adolescents attending suffer from the more severe types of
curvatures, viz.:—
Double curvatures with rotation.
Kypho-lordosis.
Severe instances of single curve.
The slighter cases such as are seen in school are in the minority and usually are cured after
two to three months attendance. Of the 92 children suffering from curvatures 33 had weak or
flat feet, 5 had slight knock-knee. In 4 cases a lateral curvature was partly due to shortness of one
leg.
Conclusions.—(1) The investigation of school children for spinal curvatures is important, but it
must be carried out without bias and is valueless unless the variety, severity and possibility of correction
of the deformity is noted.
(2) Conditions to which the curvature is secondary must be looked for carefully. In six cases
in this series the curvature was secondary to other conditions (short leg, torticollis) and the vision was
not enquired into ; defective vision is a frequent cause of kyphosis.
(3) The slighter cases of curvature should be treated by exercises in school for the following
reasons—
(a) Daily exercises are required.
(b) Attendance at a hospital or clinic necessitates expensive journeys and absence from
school.
(c) The treatment can be carried out in classes, exercises being arranged for—
1. Kyphosis.
2. Left single curves.
3. Right single curves.
(4) Proper posture is the first essential in all exercises. It is to be feared that the persistence
of many cases of kyphosis and kypho-lordosis is due to a failure in the elementary school to inculcate
a proper erect posture by teaching or example.
(5) Cases of severe curvature, specially double curves unless very slight, and kypho-lordosis,
require special individual exercises which occupy much of the instructor's time. They can only be done
by a teacher who has had training in remedial exercises, and the children should be seen at intervals
by a doctor. Unless these conditions can be complied with in school these cases should be sent to
a hospital or clinic for treatment. Regular orthopa3dic courses are now taken in many German towns
for children in ordinary elementary schools, and the Turnsaal is provided with apparatus so that
children may be supported by the heads, and by the arms fully extended over the head, whilst others
are exercised crawling round on the floor, excellent results being obtained in the slighter cases.
Anthropometry
in
Secondary
Schools,
Trade
Schools and
Training
Colleges.
In the annual report for last year statistics were given relative to the heights and weights
of boys in secondary schools, etc. The following table gives similar information in regard
to the girls in some of the Council's secondary schools, trade schools, and training colleges. The pupils have been grouped according to age last birthday.