tions, are meant to remove the muscular weakness which sometimes causes deformities, to counterbalance the evil effects of inaction on mechanical beds, to consolidate the cure, and strengthen the parts that have been straightened. Some medical men have thought to spinal deformities by gymnastics alone, and we think that slight deviations might be thus removed; but we think with all orthopedists, that gymnastics alone would not suffice to cure composed deviations, and lateral incurvations of a certain extent. But in establishments, where beds for extension are employed, gymnastic is no longer an unimportant accessary; it is positively necessary to counterbalance, by exercise, the inaction of the body stretched on mechanical beds, and to give to the debilitated muscles and tissues, a degree of strength which cannot be obtained in any other way. It is seldom that muscular weakness is general, unless there be so great a debility of constitution, that all gymnastics cannot be employed. But in most deviations or deformities, muscular weakness is but partial or relative:-thus, one side of the body is less developed, because less exercised; the muscles of the neck, which have been weakened on one side, by disease, then the muscles, the arms, or part of the spinal column; in all cases, these muscles, when partially weakened, require exercise: when there is no positive contra-indication, special gymnastic must be applied, and the muscles left in repose on the strong side. Orthopedic gymnastic consists in applying exercises suited to the degree of weakness, or state of the subject. We cannot review all the means that orthopedia borrows from gymnastics, yet shall study their action on different parts of the body. Delpech made a distinction between pure dynamic exercises, and exercises for equilibrium; by the first, he endeavoured to preserve the vertebræ from the pressure of the weight of the superior parts; by the second, he sought the proper means to prevent any muscle being deprived of movement. Without exactly following this division, it may guide us in the enumeration of gymnastic means. The first exercises are intended to exercise the superior limbs by suspension, so that the weight of the body falls below, and thus causes the column to be straight. Among this number, are exercises on the straight ladder, then on a spiral ladder, then on rope ladders, and then on ladders placed horizontally, and triangles; but these exercises, that nearly all orthopedists have pointed out as desirable, and that we advise to develop the chest, are nearly all contra-indicated in the anormal and irregular development of the body, as they exercise both sides in an equal degree; so that all the muscles are strengthened, without the deformity being cured. The physician presiding over these exercises, modifies them according to the individualities. Thus, the young patients must go up the spiral ladder on one side, the horizontal ones slightly inclined, the triangle not straight, one of its extremities should be more elevated than the other; without the strictest attention on the part of the medical attendant, special gymnastic is but a word. In these exercises, extension by the weight of the body is always combined with traction of the muscles, the aid both of hands and feet are required; as strength is gained, the weight of the body is supported by the hands alone. These exercises should be avoided when the patient is weak or scrofulous, for the extension of the ligaments uniting the vertebræ could but increase the general weakness. All exercises for suspension, should only be followed when the patient has acquired a certain degree of strength, by preparatory exercises. In a work that we have endeavoured to render concise, we cannot give a minute detail of all the varied exercises we have seen in the gymnasia of La Muette, Colonel Amoros, Madame Masson, and other institutions of Paris, as well as the too few establishments in and near London. We cannot even here enter into an explanation of our own ideas: suffice it to say, that orthopedic gymnastic may cure slight devia |