a prominence in the left flank which masks
the outline of the iliac crest on that side, while the right flank
shows a deep furrow and the right half of the pelvis is unduly
prominent. There is a slight compensatory curve to the right in the
thoracic region, and the right side of the chest projects backwards.
The brachio-thoracic triangle is much more marked on the right than on
the left side.

_Diagnosis of Adolescent Scoliosis._--In many cases the patient is
brought to the surgeon on account of pain and weakness in the back
before any distinct deviation has developed, and, unless a careful
examination is made, the real cause of the symptoms is liable to be
overlooked.

The patient should be stripped and examined in a good light in various
attitudes; for example, standing in an easy position, standing as
straight as she can, and sitting on a flat stool. She should also be
asked to read from a book and to write, in order to exhibit her usual
attitudes. In early cases, an inequality in the level of the angles of
the scapulae is often the only physical sign to be detected. It should
also be observed whether the line of the spines is altered when the
patient hangs from a horizontal bar or trapeze. Any backward
projection of the ribs on one side is rendered more obvious if the
patient folds the arms across the chest and bends well forward, while
the surgeon looks along the back from behind.

Pott's disease may be excluded by the absence of rigidity. Any
mechanical cause of deviation of the spine, such, for example, as
inequality in the length of the limbs or contraction of the chest
after empyema, must be sought for. Scoliosis that depends upon
inequality in the length of the limbs or tilting of the pelvis,
disappears on sitting.

_Treatment._--The treatment of postural scoliosis implies a
comprehensive programme, including attention to the general health,
habits, and exercises out of doors and in the gymnasium, clothing,
etc., all requiring supervision over a period of months, or even of
years. The object of the treatment is to correct the deformity before
the position has become fixed by rotation of the vertebrae and
alteration in their shape. The child must not be allowed to assume
awkward attitudes while reading, writing, or playing the piano; she
must sit on a low chair, the seat of which slopes slightly downwards
and backwards, and the back rest of which reaches as high as the
shoulders, and is at an angle of 10