dren the same means, for all children are not alike.

While advancing in the study of physical education, we shall often have to notice the immense influence of the diathesis of which we have spoken, in producing numerous deformities of the spine, and other parts of the body.

Thus, the more physical education is studied, the more complicated it proves. The infant coming from the hands of nature is not always healthy, and there would be but few opportunities of applying the precepts and sophisms of the philosopher of Geneva, if they were only calculated for children who come into the world with the original perfection, nearly alike to that with which the first man came from the hands of God.

CHAP. VI.

On the causes of Constitutional or acquired Deformities.

THE most common source of deformity is, without doubt, to be traced to the state of the constitution. With a scrofulous, rachitic, or tuberculous diathesis, or with an anormal development of the nervous state, accidental causes are not necessary to produce deformity. Deviations in the anormal state may then occur without any accidental, or apparent cause; and it is for this reason we gave so much importance to morbid diathesis: it is certainly not possible to obtain perfect cures, and to restore deviations, unless the economy has acquired sufficient strength to maintain them. General health, or what is termed the normal state of the body, is the first condition for all cures, or for the return to the regular laws of organization. All attempts to straighten the spinal column will be useless; the cure will be but temporary, unless the tissues of the economy have acquired normal vitality and strength: a spinal deviation cannot be permanently cured if attention be given to the spinal column alone. One particular organ cannot be isolated from the whole economy; it cannot be freed from the general influences acting on the whole human frame. But it often happens, that

if a deviation be noticed in its early stage, by strengthening the general health the deviation will be cured. In all times orthopedists have failed in this respect, particularly those who do not belong to the faculty, and who only have recourse to local means, in cases where enlightened care is imperiously demanded.

It is an error to suppose that in the morbid changes which take place in the economy, the effect is visibly connected with the cause, and that it is easy to trace the one to the other; the disorders of the functions, and of the organs, are not like those of physics and mechanics; there is more in the economy than mechanism,— more than mere bones and muscles; and there are numerous phenomena to which the laws of physics cannot be applied.

Deformities or deviations from the normal state have several sources; the state of the constitution, which predisposes to every sort of deviation; the diseases which weaken the economy, and render it susceptible to all the influences of a bad education; or this mixture of attitudes and habits so often repeated, that, according to the vulgar expression, they become second nature. In the first case, deformities or deviations from the normal state sometimes appear at birth; at other times, they are developed during growth in the second case, deviations or deformities are the result of disease: in the third case, they are the effect of attitudes and habits, which have very

great influence on weak constitutions, and more particularly on individuals born with morbid predispositions, or those debilitated by long ill

ness.

In these different states, it must be understood, that it will not suffice merely to use appa. ratus to re-establish the individual; the question is not merely to draw the spinal column straight, but to give a proper degree of care to the whole constitution. These considerations will prove to parents, that the education of the anormal state requires an enlightened direction, and that the cure of deformities or deviations cannot be confided to drilling masters, nor men ignorant of the healing art. These observations are requisite before we discuss the causes, and the means of re-establishment.

The disposition to the curvature of the limbs and spine, depends therefore much on the primitive constitution, which has mostly a character of weakness easily discerned. It may be said that all weak persons are subject to spinal complaints, whether the weakness be constitutional or the result of any illness. "If we question any person afflicted with spinal diseases," says Dr. Duval, "we shall nearly always find that in childhood they have been subject to convulsions, that they suffered much from measles, hooping cough, glandular swellings, or some other diseases."

This fact once established, there would be

two things to consider in spinal affections.. First, the constitutional state, then local deviations, which are to be brought to their normal state. However simple this distinction may appear, the knowledge of the real cause of deformities offers innumerable difficulties. Drs. Bouvier and Delpech were of opinion that spinal deviations were the result of several combined causes, and that it was not always easy to discover and to explain them.

Indeed, to apply to the subject to which we now devote our attention a knowledge of the causes of deformities, is no slight task. For the muscles and bones to exercise their functions regularly, there must be physical and normal integrity of these organs: whatever may modify or destroy this integrity, may also modify the functions of locomotion and station. Thus the muscles and bones are subjected to all the causes that may act on the whole economy, and these causes are very numerous. Besides the morbid predispositions we have noticed, all external and internal agents, all those which modify the functions of nutrition and enervation, may also modify the structure, the solidity, and vitality of the bones and muscles. When the bones have not acquired a proper degree of solidity they are unable to bear the effort of the muscles; and if the power of the muscles be not equal, they act unequally on the bones, which if weak are easily deviated.

DD