e right or
left. The pathologists divide scoliosis into a myopathic variety, in
which the trouble is a physiologic antagonism of the muscles; or
osteopathic, ordinarily associated with rachitis, which latter variety
is generally accountable for congenital scoliosis. In some cases the
diameter of the chest is shortened to an almost incredible degree, but
may yet be compatible with life. Glover speaks of an extraordinary
deformity of the chest with lateral curvature of the spine, in which
the diameter from the pit of the stomach to the spinal integument was
only 5 1/2 inches.

Supernumerary ribs are not at all uncommon in man, nearly every medical
museum having some examples. Cervical ribs are not rare. Gordon
describes a young man of seventeen in whom there was a pair of
supernumerary ribs attached to the cervical vertebrae. Bernhardt
mentions an instance in which cervical ribs caused motor and sensory
disturbances. Dumerin of Lyons showed an infant of eight days which had
an arrested development of the 2d, 3d, 4th, and 5th ribs. Cases of
deficient ribs are occasionally met. Wistar in 1818 gives an account
of a person in whom one side of the thorax was at rest while the other
performed the movements of breathing in the usual manner.

In some cases we see fissure of the sternum, caused either by deficient
union or absence of one of its constituent parts. In the most
exaggerated cases these fissures permit the exit of the heart, and as a
general rule ectopies of the heart are thus caused. Pavy has given a
most remarkable case of sternal fissure in a young man of twenty-five,
a native of Hamburg. He exhibited himself in one medical clinic after
another all over Europe, and was always viewed with the greatest
interest. In the median line, corresponding to the absence of sternum,
was a longitudinal groove bounded on either side by a continuous hard
ridge which articulated with the costal cartilages. The skin passed
naturally over the chest from one side to another, but was raised at
one part of the groove by a pulsatile swelling which occupied the
position of the right auricle. The clavicle and the two margins of the
sternum had no connections whatever, and below the groove was a hard
substance corresponding to the ensiform cartilage, which, however, was
very elastic, and allowed the patient, under the influence of the
pectoral muscles, when the upper extremity was fixed, to open the
groove to nearly the extent of three