The success attending the following case in so short a time as a fortnight I ascribed principally to the use of the warm bath; in which the patient continued for full half an hour every night, in the degree of heat, which was most grateful to her sensation, which might be I suppose about 94. Miss ——, about ten years of age, and very tall and thin, has laboured under palpitation of her heart, and difficult breathing on the least exercise, with occasional violent dry cough, for a year or more, with dry lips, little appetite either for food or drink, and dry skin, with cold extremities. She has at times been occasionally worse, and been relieved in some degree by the bark. She began to bend forwards, and to lift up her shoulders. The former seemed owing to a beginning curvature of the spine, the latter was probably caused to facilitate her difficult respiration.

M. M. She used the warm bath, as above related; which by its warmth might increase the irritability of the smallest series of vessels, and by supplying more moisture to the blood might probably tend to carry further the materials, which form calcareous or bony particles, or to convey them in more dilute solution. She took twice a day twenty grains of extract of bark, twenty grains of soda phosphorata, and ten grams of chalk, and ten of calcined hartshorn mixed into a powder with ten drops of laudanum; with flesh food both to dinner and supper; and port wine and water instead of the small beer, she had been accustomed to; she lay on a sofa frequently in a day, and occasionally used a neck-swing.

[15]. Rachitis. Rickets. The head is large, protuberant chiefly on the forepart. The smaller joints are swelled; the ribs depressed; the belly tumid, with other parts emaciated. This disease from the innutrition or softness of the bones arose about two centuries ago; seems to have been half a century in an increasing or spreading state; continued about half a century at its height, or greatest diffusion; and is now nearly vanished: which gives reason to hope, that the small-pox, measles, and venereal disease, which are all of modern production, and have already become milder, may in process of time vanish from the earth, and perhaps be succeeded by new ones! See the preceding species.

[16]. Spinæ distortio. Distortion of the spine is another disease originating from the innutrition or softness of the bones. I once saw a child about six years old with palpitation of heart, and quickness of respiration, which began to have a curvature of the spine; I then doubted, whether the palpitation and quick respiration were the cause or consequence of the curvature of the spine; suspecting either that nature had bent the spine outwards to give room to the enlarged heart; or that the malformation of the chest had compressed and impeded the movements of the heart. But a few weeks ago on attending a young lady about ten years old, whose spine had lately began to be distorted, with very great difficulty and quickness of respiration, and alarming palpitation of the heart, I convinced myself, that the palpitation and difficult respiration were the effect of the change of the cavity of the chest from the distortion of the spine; and that the whole was therefore a disease of the innutrition or softness of the bones.

For on directing her to lie down much in the day, and to take the bark, the distortion became less, and the palpitation and quick respiration became less at the same time. After this observation a neck-swing was directed, and she took the bark, madder, and bone-ashes; and she continues to amend both in her shape and health.

Delicate young ladies are very liable to become awry at many boarding schools. This is occasioned principally by their being obliged too long to preserve an erect attitude, by sitting on forms many hours together. To prevent this the school-seats should have either backs, on which they may occasionally rest themselves; or desks before them, on which they may occasionally lean. This is a thing of greater consequence than may appear to those, who have not attended to it.

When the least tendency to become awry is observed, they should be advised to lie down on a bed or sofa for an hour in the middle of the day for many months; which generally prevents the increase of this deformity by taking off for a time the pressure on the spine of the back, and it at the same time tends to make them grow taller. Young persons, when nicely measured, are found to be half an inch higher in a morning than at night; as is well known to those, who inlist very young men for soldiers. This is owing to the cartilages between the bones of the back becoming compressed by the weight of the head and shoulders on them during the day. It is the same pressure which produces curvatures and distortions of the spine in growing children, where the bones are softer than usual; and which may thus be relieved by an horizontal posture for an hour in the middle of the day, or by being frequently allowed to lean on a chair, or to play on the ground on a carpet.

Young ladies should also be directed, where two sleep in a bed, to change every night, or every week, their sides of the bed; which will prevent their tendency to sleep always on the same side; which is not only liable to produce crookedness, but also to occasion diseases by the internal parts being so long kept in uniform contact as to grow together. For the same reason they should not be allowed to sit always on the same side of the fire or window, because they will then be inclined too frequently to bend themselves to one side.

Another great cause of injury to the shape of young ladies is from the pressure of stays, or other tight bandages, which at the same time cause other diseases by changing the form or situation of the internal parts. If a hard part of the stays, even a knot of the thread, with which they are sewed together, is pressed hard upon one side more than the other, the child bends from the side most painful, and thus occasions a curvature of the spine. To counteract this effect such stays, as have fewest hard parts, and especially such as can be daily or weekly turned, are preferable to others.