trying to correct the stoop is to put on some instrument by which the
shoulders and the head are held back. To operate upon the shoulders,
the common back-collar is applied, and to hold back the head, a
riband is brought over the forehead and fastened to the collar.
While these instruments are kept on, the figure looks straight,
though stiff and constrained; but the moment they are taken off,
both the head and the shoulders fall more forward, than before
their application. Many examples of the bad effect of artificially
supporting the head might be offered. The following, although
observed in the figure of a horse, is very demonstrative. When the
rein (called the bearing-rein), by which the head of a carriage-horse
is reared up, with the intention of giving him a showy figure, is
loosened, the head immediately falls forward, and the neck, instead
of preserving the fine arch that is so much admired, droops between
the shoulders. Looking to this effect, we should at first be inclined
to condemn the practice followed by horse-dealers, of reining up
the head of a young horse in the stable, by means of the apparatus
called a dumb-jockey. But on examining into this mode of fixing
the head, it will be found to operate on a different principle from
the bearing-rein. Instead of a [p238] simple bit, such as the horse
in harness can lean his head upon, without suffering pain, a bit,
calculated to tease and fret, is put into the young horse’s mouth.
To relieve himself from the irritation produced by this, and which
is increased by the constant pull of the elastic piece of iron to
which the rein is fastened, he curls up his neck, and thus brings
all the muscles of the back of the neck into strong action, instead
of allowing their power to be superseded by the artificial support
afforded by the bearing-rein to the horse in harness[38].
Many different contrivances, but all acting nearly on the same
principle as the _bearing-rein_, have been proposed as means for
obliging a girl to keep her head erect.
[Illustration]
There is one mode which, to a person ignorant of anatomy, seems to be
particularly well adapted for this purpose; but it is, in fact, more
objectionable than the plan of tying the head back with a riband. A
piece of lead, of some pounds weight, [p239] is slung over the back
in such a way that it must be supported by a riband put around the
head.
Although this contrivance prevents the head for a time from falling
forwards, its bad effects may be demonstrated. When the weight is on,
the muscles of the back of the spine are passive, while those on the
fore-part of the neck are necessarily brought into action to prevent
the head from being pulled too far back: this is easily proved; for
if we put the fingers on the sternal portions of the sterno-cleido
muscle, which, with the small muscles on the fore-part of the throat,
pull the head forwards, we shall feel them tense and in action. The
increased activity of the muscles on the fore part, and the passive
condition of those of the back, may be further exemplified by raising
the weight when the girl is not aware of our doing so; the head will
then be immediately poked forwards.
We have many opportunities of observing the incorrectness of the
principle on which all similar plans for the cure of a stoop have
been founded. For instance, porters who carry burthens on the back,
by the assistance of a band round the forehead, always stoop; while
those who carry baskets before them suspended by a band round the
back of the neck, are peculiarly erect. But the most remarkable
example of the effect of the head being pulled back by a weight hung
behind, is the condition of the women who carry salt in the streets
of Edinburgh, for they may be recognised as much by their miserable
Sardonic grin, which is caused by the constant excitement of the
platysma myoides muscle, as by their stoop.
Very annoying and even distressing consequences may ensue from any
system of treatment where a constant resistance to the muscles of
the fore-part of the neck is kept up. A gentleman had for many
years worn one of the collars invented by Mr. Chesher; after some
time, the muscles of the back became so weak, as to be incapable
of supporting the column, while those on the fore-part of the neck
were so disproportionately increased in strength, by the constant
resistance opposed to them by the strap passing from the suspending
rod under the chin, that whenever the strap was loosened, the chin
was forcibly drawn towards the chest. As the muscles of the back part
of the neck did not offer any counteracting resistance, the [p240]
windpipe was now pressed down, or almost doubled itself. As soon as
this took place (and it was almost immediate on the attempt to sit
up without the collar,) the patient was seized with such a sense of
suffocation, as to be obliged to throw himself on his back. As he was
able to breathe with ease as he lay on his back, his advisers were
led to believe that it was the weight of the head which pressed down
the windpipe. To counteract this pressure, various contrivances had
been proposed to support the head. Indeed, the patient himself was
so convinced, from what he had heard, that it was the weight of the
head which pressed down the windpipe, and so alarmed had he become
from the certainty of having a fit of suffocation when the head was
left unsupported, that there was much difficulty in persuading him
to believe that if the head could be made _heavier_, the sense of
suffocation would be relieved. He was at length induced, although
with great dread of the consequence, to allow about fourteen pounds
of shot to be placed on the top of his head. He was very much
alarmed, but it was highly gratifying to witness his surprise and
pleasure in finding that, instead of his head being weighed down, he
could support it, and could breathe with ease while in the upright
posture. The following is the principle on which this plan was
proposed:—the muscles of the back part of the neck had been brought
into such a state, that their ordinary stimulus was not sufficient
to excite them to the action necessary to counteract the efforts
of those on the fore-part of the neck, which had been evidently
increased in strength. The placing a weight on a certain spot on the
head formed an additional stimulus to the muscles of the back part
of the neck; a fact which the reader may prove by an experiment on
himself.
By proceeding on this principle, by combining a variety of exercises,
and by gradually diminishing the weight carried on the head, this
gentleman was soon able to walk and sit in a state of great comfort,
without being obliged to use any artificial support.
It is well known, that the neck-collars support almost the whole
weight of the head and shoulders by the strap which passes under
the chin. It must also have been observed, that the wearer very
frequently pushes down the head against the [p241] chin strap. In
this way, the muscles on the fore-part necessarily become stronger,
while those of the back, being deprived of their natural stimulus to
action, in consequence of the rod superseding their office, become
diminished in power. Even were there no change in the degree of
strength in the muscles on the fore-part, the head would naturally
fall, if the support afforded by the chin strap were removed; but as
these muscles are increased in power, while those of the back are
diminished, the head must not only fall, but even be pulled down.
However, although the collars and the lead weight, as they are
generally used, are not only inefficacious; but even hurtful,
they may occasionally be useful in keeping the head in a certain
position, after it has been brought to it by such exercises as tend
to strengthen those muscles of the back which support the shoulders
and head. But the opinions commonly entertained, as to the means of
counteracting an habitual stoop, are so erroneous, that even the
position of a tailor sitting on his shopboard is better than the
plans generally recommended. This at first appears ridiculous; but
the manner a tailor holds his body when he walks, proves that there
is something in his habits which tends to the correction of a stoop;
for he is quite a caricature of a strutting erect figure, especially
in the way he bends in his loins and carries his head.
The peculiarity of the tailor’s gait proceeds, in a certain degree,
from the bent position in which he sits: but this explanation is not
at first satisfactory, since it may be observed that other tradesmen,
who also stoop while at work, generally have their head inclined
forwards, and have also a distinct and habitual bend in the neck;
such, especially, is the condition of persons who sit at a table and
stoop forwards, as watchmakers, engravers, &c. It is not difficult
to explain the cause of the difference, and the inquiry will assist
in directing us to the principles which we ought to recollect in our
operations upon the spine.
In the sitting position of the tailor, the head hangs so low, and
so complete an arch is formed between it and the pelvis, that the
muscles of the spine are called into strong action to support the
head; the necessary consequence of this is, that these muscles become
even unnaturally strong, or at least so strong as to predominate
over those by which the spine is [p242] pulled forward. But the
bent position is not the only cause of increase in the strength of
the muscles, for it depends also on the exercise given by frequently
jerking the head backwards. In those who stoop from the middle of
the body, as in writing or working at a table, the muscles of the
spine are not called into action; for, while the head is in this
position, it rests or is supported by the ligament of the neck.
The ligament, being thus kept constantly on the stretch, becomes
lengthened, instead of being made more contractile, as muscles would
be; and hence the stoop is increased. When this is combined with the
consequences of the want of muscular action, the deeper ligaments,
which bind the upper vertebræ, gradually yield; if the operation of
these causes continues for a certain time, the bones and cartilages
themselves become altered in shape, and consequently an almost
irremediable stoop is produced[39].
This view derives confirmation, from what may be observed in the
shape of the tailors in some parts of Germany, who, instead of having
the erect figures of London tailors, are quite bent. On inquiring
into the cause, we find that, instead of sitting as tailors do in
this country, a hole is cut in the table, and a seat is placed within
it; so that their position, while working, becomes nearly the same as
that of persons who stoop while sitting at a table.
It may, perhaps, be objected, that labourers, and especially the
vine-dressers in France, are remarkable for the complete arch which
their body forms, although they bend while at work as much as the
tailor does. This may also be explained; for in the labourer the bend
is produced by the pelvis rolling on the head of the thigh bones,
while in a person sitting as a tailor the pelvis continues nearly
fixed, and the bend is in the vertebræ on the pelvis.
The erect figure of the Turk perhaps comes from the manner of sitting
which is common among Eastern nations; but the heavy turban, and the
spice box slung from the back of the neck, may account in a great
measure for the fine figures of the Turkish Jews who frequent the
streets of London. [p243]
We may even take the shoemaker as an example of the effect of a
particular manner of sitting, and of frequently using the muscles
of the shoulders. He is also a little in caricature, but he carries
himself better than the tailor, and the cause is obvious. The
tailor’s figure is very erect, but the right shoulder is generally
a little higher or larger than the left, from the constant exercise
given to the right arm, while the left rests upon the knee: this
inequality of the shoulders is not observed in the shoemaker, because
he not only uses both arms equally, but the muscles by which the
scapulæ are supported, become so strong by the habit of jerking back
his elbows while he works, that his shoulders always appear more
braced back than those of any other class of persons: indeed, so
characteristic are the figures of tailors and shoemakers, that they
may be easily distinguished in a crowd.
These circumstances are mentioned, as they afford familiar examples
of the principles on which we ought to proceed, in endeavouring
to correct deformities; but it would be ridiculous to propose the
position either of the tailor or of the shoemaker, as the best
adapted to correct a stoop or falling forward of the shoulders.
The preceding observations apply also to the contrivances usually
employed to keep the shoulders back, and particularly to the question
of the propriety of using the common back-collar. The effect which
this instrument produces in ordinary cases may be easily comprehended
by the following diagram.
[Illustration]
[p244]
The part of the back formed by the ribs is not a flat, but rather a
round surface; and as the shoulder-blades rest on this, they would
fall forwards were they not prevented by the collar-bones; but as
these bones are united to the breast-bone by a moveable joint, and
as the weight of the arms operates principally on the anterior
angles of the scapulæ, both the collar-bones and the shoulders would
fall forwards, were it not for the action of several strong muscles
which pass from the spine to the scapulæ. But these muscles may be
destroyed by any contrivance which supersedes their use. For example,
let A A be the shoulder-blades, and B B the muscles which support
them. If the scapulæ be brought close to the spine by the straps
of the collar, and kept constantly so, there can be no use for the
muscles B B. They must consequently waste and become nearly useless,
while those on the fore-part of the chest, being excited to resist
the straps, will become increased in power; and hence, when the
collar is taken off, not only will the shoulders fall forward as in a
delicate person, but the muscles on the fore-part of the chest will
predominate over those by which the scapulæ should be held back, and
_pull_ the shoulders forwards.
The spine and the ribs are occasionally bent so as to have some
resemblance to the back of a spoon. In such cases, the shoulders
not only appear high and round, but the lower angles of the scapulæ
project in an extraordinary manner, because the upper and anterior
angle is not only unsupported by the ribs, but is dragged forwards
by the clavicles which are carried in the same direction with the
sternum. When this is to a considerable extent, it constitutes
the _contracted chest_ or the _chicken breast_. This, in a slight
degree, is common in London, and especially among young lads; it
may be discovered by the coat having the appearance of being more
worn opposite the lower angle of the scapula than at any other part.
Such a condition of the chest can only be completely remedied by
appropriate exercises; but a collar is here necessary for a time, to
keep the bones in the improved condition into which they are brought
by the exercises.
These arguments will probably appear sufficiently well founded to
prove that a girl, under ordinary circumstances, [p245] cannot hold
her head or shoulders back, unless the muscles by which they are
naturally supported are in a proper condition. Various contrivances
have been proposed to strengthen these muscles. Dumb bells, if
managed in a particular manner, are good; skipping, when the arms are
thrown backwards and over the head, is still better; the exercises,
called Spanish exercises, performed with two long poles, are also
useful, but to each of these there may be objections, as they all
operate more or less on the spine or ribs, which, in case of a bad
stoop, are generally affected.
The following anecdote will, perhaps, set the question of the
propriety of wearing the back collar in a correct point of view. A
surgeon was consulted by a gentleman, who is now one of our first
tragedians, as to the best mode of correcting a stoop which he had
acquired. The surgeon told him that neither stays nor straps would do
him any essential good; and that the only method of succeeding was to
recollect to keep his shoulders braced back by a voluntary effort.
But the tragedian replied, that this he could not do, as his mind was
otherwise occupied. The surgeon then told him that he could give him
no further assistance. Shortly after this conversation, the actor
ordered his tailor to make a coat of the finest kerseymere, so as to
fit him very tightly, when his shoulders were thrown back. Whenever
his shoulders fell forward he was reminded by a pinch under the arms,
that his coat cost him six guineas, and that it was made of very
fragile materials; being thus forced, for the sake of his fine coat,
to keep his shoulders back, he soon cured himself of the stoop. The
surgeon was much obliged to him for the hint, and afterwards, when
consulted whether young ladies should wear shoulder straps, permitted
them, on condition that they were made of fine muslin, or valuable
silk, for tearing which there should be a forfeit.
An inquiry into the manner a girl should sit may appear trifling
to those who have not been in the habit of seeing many cases of
distortion of the spine, but it is intimately connected with the
present subject, and is really of considerable importance. The
question has been disputed; one party insisting that girls should
always sit erect, while others are advocates for a lounging position.
It is not difficult to show that both are [p246] wrong;—when a
delicately formed girl is supposed to be sitting erect, she is
generally sitting crooked: to a superficial observer she may appear
quite straight; but any one who will sit on a music stool, and
endeavour to keep his body in a perpendicular line for ten minutes,
will be convinced that it is difficult for even a strong man to sit
as long as a delicate girl is expected to do, without allowing the
spine to sink to one side or to fall forwards.
The attempt to sit erect beyond a certain time is injurious, for
although bending the spine occasionally is useful rather than
hurtful, yet when it is done involuntarily, and when the bend is
attempted to be concealed by an endeavour to keep the head straight,
there is danger of the spine becoming twisted. Indeed, a double curve
is generally the consequence; there is first a bend to one side, to
give ease to the fatigued muscles; and then, to conceal this, there
is a second curve that is necessarily accompanied by a slight twist
in the vertical line of the whole column.
The proposal to allow children to sit in a crooked or lounging
position seems to have been founded on the idea that all the muscles
are more relaxed in this way than even when the child lies at full
length on its back. This notion is certainly incorrect, and such a
mode of sitting is injurious; for even were the muscles more relaxed
by it, the bones and ligaments acquire such a shape as necessarily
produces distortion.
It may naturally be asked how a girl should sit, since it would
appear, that whether she is in an erect or stooping posture, she is
equally in danger of becoming crooked. As sitting, in the manner
generally recommended, affords little or no support to one who is
weak, the safest answer would be, that a delicate girl should not sit
for even more than five or ten minutes without having some support
to her back, and when she is fatigued, that she should lie down or
recline on a couch. But as it would be very annoying to a girl not to
be allowed to sit up except for so short a time, and as a couch is
not always at hand, we must endeavour to show how a delicate girl may
remain in an upright posture, for a reasonable time without incurring
any risk of becoming crooked. This leads to an inquiry into the
merits of the chairs which are at present generally used by children.
[p247]
Young ladies are often obliged, while at their music lessons, to
sit upon those chairs, which have high backs, long legs, and small
seats. These chairs are said to have been invented by a very eminent
surgeon, and are intended, either to prevent distortion, by some
supposed operation on the spine, or as the most effectual means of
supporting the body. It is difficult to imagine how a chair of this
description can effect the first purpose; and to discover how far it
is calculated for the second, the reader should make the experiment
on a chair of the same proportion to his figure, as the chair in
question is to that of a little girl. He will find that if the seat
or surface on which he rests is small in proportion to his body, the
chest will, after a time, either fall forward or to one side, unless
he exert himself to a degree that is very fatiguing. Indeed, if the
seat be at the same time so high, that the feet do not rest fairly
on the ground, but dangle under the chair, a forward position of the
head is almost necessary to preserve the balance of the figure[40].
The objections to such chairs have been met with the assertion, that
girls feel remarkably comfortable in them. This is no argument in
favour of their use, for it is not uncommon for a girl who has seven
or eight pounds of iron strapped upon her body and next to her skin,
to say the machine annoys her so little, that she does not care how
long she wears it.
But whether this chair is agreeable or not, it is easy to show that
it is not calculated to give much proper support to the body, and
that it is almost impossible for a delicate girl to sit long in a
natural or easy position upon it.
It may be allowed, that the chair which we consider the most
comfortable, that is, the chair which affords the most support to
the body, should, if made in proper proportions, be the best for a
delicate girl. In such a chair, the _seat_ should be scarcely higher
than the knees (thus permitting the whole of the foot to rest on
the floor), and of such a size, that on sitting back, the upper
part of the calves nearly touch it. This form of _seat_ is very
different from that of the chair alluded to, the _back_ of which is
also equally objectionable, for, instead of being in [p248] some
degree shaped to the natural curves of the spine, it is made nearly
straight, and projects so as to push the head forwards. A delicate
girl should always sit so as to rest against the back of the chair,
and, if the lower part of her spine is weak, a small cushion will
afford great relief. As it is quite a mistake to suppose that the
shoulders, if raised in any other way than by the action of the
muscles, or by the curvature of the spine and ribs, will continue
high, there is no real objection to a girl who is delicate being
supported by an arm-chair; for, by occasionally resting on the
elbows, a considerable weight is taken off from that part of the
spine which is the most likely to yield.
These observations refer only to the manner in which delicate girls,
whose spines are still straight, should sit: when the spine is
actually distorted, it will be necessary to use other means.
FOOTNOTES:
[37] For this, and some other communications upon the same
subject, we are chiefly indebted to our much-lamented friend and
correspondent, the late Mr. Shaw, Surgeon to the Middlesex Hospital.
[38] When the Russians wish to give a horse high action in trotting,
they accustom him, while young, to wear heavy shoes on the fore
feet. The resistance to be overcome necessarily increases the
strength of certain muscles; and hence, when shoes of the common
size are put on, the horse lifts his feet higher than one which has
not been subjected to this discipline. Some opera dancers practise
with lead weights on.
[39] Elderly persons may recollect how often the girls who worked
at _tambouring_ were crooked: the present fashionable amusement of
embroidering seems to have, in some instances, the same effect.
[40] It must be almost unnecessary to remind the reader, that if the
knees are bent in standing or walking, there is a curve in the spine
at the same time.
_A Critique on the Aplanatic Object-Glasses, for diverging Rays, of_
Vincent Chevalier, ainé et fils. _By_ C. R. Goring, M.D.