367. My daughter has grown out of shape, she has grown on one ride, her spine is not straight, and her ribs bulge out more on the one side than on the other; what is the cause, and can anything be done to remedy the deformity?
The causes of this lateral curvature of the spine, and consequent bulging out of the ribs that you have just now described, arise either from delicacy of constitution, from the want of proper exercise, from too much learning, or from too little play, or from not sufficient or proper nourishment for a rapidly-growing body. I am happy to say that such a case, by judicious treatment, can generally be cured—namely, by gymnastic exercises, such as the hand-swing, the fly-pole, the patent parlour gymnasium, the chest-expander, the skipping rope, the swimming bath; all sorts of out-door games, such as croquet, archery, &c.; by plenty of good nourishment, by making her a child of Nature, by letting her almost live in the open air, and by throwing books to the winds. But let me strongly urge you not, unless ordered by an experienced surgeon, to allow any mechanical restraints or appliances to be used. If she be made strong, the muscles themselves will pull both the spine and the ribs into their proper places, more especially if judicious games and exercises (as I have before advised), and other treatment of a strengthening and bracing nature, which a medical man will indicate to you, be enjoined. Mechanical appliances will, if not judiciously applied, and in a proper case, waste away the muscles, and will thus increase the mischief; if they cause the ribs to be pushed in in one place, they will bulge them out in another, until, instead of being one, there will be a series of deformities. No, the giving of strength and the judicious exercising of the muscles are, for a lateral curvature of the spine and the consequent bulging out of one side of the ribs, the proper remedies, and, in the majority of cases, are most effectual, and quite sufficient for the purpose.
I think it well to strongly impress upon a mother's mind the great importance of early treatment. If the above advice be followed, every curvature in the beginning might be cured. Cases of several years' standing might, with judicious treatment, be wonderfully relieved.
Bear in mind, then, that if the girl is to be made straight, she is first of all to be made strong; the latter, together with the proper exercises of the muscles, will lead to the former; and the earlier a medical man takes it in hand, the more rapid, the more certain, and the more effectual will be the cure.
An inveterate, long-continued, and neglected case of curvature of the spine and bulging out of the ribs on one side might require mechanical appliances, but such a case can only be decided on by an experienced surgeon, who ought always, in the first place, to be consulted.
368. Is a slight spitting of blood to be looked upon as a dangerous symptom?
Spitting of blood is always to be looked upon with suspicion; even when a youth appears, in other respects, to be in good health, it is frequently the forerunner of consumption. It might be said that, by mentioning the fact, I am unnecessarily alarming a parent, but it would be a false kindness if I did not do so:—
"I most be cruel, only to be kind."—Shakspeare.
Let me ask, When is consumption to be cured? Is it at the onset, or is it when it is confirmed? If a mother had been more generally aware that spitting of blood was frequently the forerunner of consumption, she would, in the management of her offspring, have taken greater precautions; she would have, made everything give way to the preservation of their health; and, in many instances, she would have been amply repaid by having the lives of her children spared to her. We frequently hear of patients, in confirmed consumption, being sent to Mentone, to Madeira, and to other foreign parts. Can anything be more cruel or absurd? If there be any disease that requires the comforts of home—and truly may an Englishman's dwelling be called home!—and good nursing more than another, it is consumption.
369. What it the death-rate of consumption in England? At what age does consumption most frequently occur? Are girls more liable to it than boys? What are the symptoms of this disease?