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118
the desks have been accused. This is a reasonable
possibility and it requires little imagination to see that a
bad desk would predispose to the development of a
postural defect. But improvement in the construction of
desks has not abolished postural deformities, and there
is some more potent, and more obscure, factor at work.
Mr. Philip Wiles, who has paid considerable attention to
this subject, is of the opinion that the loss of muscular
control seen in cases of postural deformity is often of
nervous origin, and it is probable that the hours of
sedentary work, the sudden diminution in the hours of
play that occur when a child goes to school, and the
burden of home work are all to blame.
The whole problem calls for thorough investigation,
and it is possible that ultimately drastic alteration in hours
of work at school may have to be made, at least in certain
cases.
Fortunately, most of these cases respond well to
remedial exercises, though it should not be forgotten that
improvement may, in some cases, be due to the cutting
down of hours at school necessitated by the treatment.
In the near future the question of additional facilities
for exercises, remedial and otherwise, will be coming
under consideration and it is to be hoped that further
provision will be made at an early date. There is much
to be said for children with postural defects being under
the care of a physical exercise instructor provided that the
child has passed a preliminary inspection at the
orthopaedic clinic, and organic disease has been excluded.
These children should not be allowed to think that they
are considered as cripples, which, indeed, they are not.
Hospital Work.
I regret to report that one child, aged 18 months, died
in hospital. When she first attended the clinic she was
suffering from rickets and bronchitis. As she failed to
improve, admission to hospital was advised. Her general