. Lateral curvature of the spine and round shoulders . Abnormalcurves in the anteroposterior plane also occur. 2. MALFORMATIONS OF THE elevation of the scapula (Sprengels deformity) willcause a scoliosis which is usually a high cervicodorsal curve with com-pensating dorsolumbar curve, One scapula is occasionally ab- sent or malformed (Fig. 69). 3. MALFORMATION OF THETHORAX. Occasionally great irregu-larity characterizes the ribs ofone or both sides. Some maybe bifurcated, while others aredeficient. Such irregularitiesare a cause of scoliosis. Heredity must also be con-sidere
. Lateral curvature of the spine and round shoulders . Abnormalcurves in the anteroposterior plane also occur. 2. MALFORMATIONS OF THE elevation of the scapula (Sprengels deformity) willcause a scoliosis which is usually a high cervicodorsal curve with com-pensating dorsolumbar curve, One scapula is occasionally ab- sent or malformed (Fig. 69). 3. MALFORMATION OF THETHORAX. Occasionally great irregu-larity characterizes the ribs ofone or both sides. Some maybe bifurcated, while others aredeficient. Such irregularitiesare a cause of scoliosis. Heredity must also be con-sidered, as it is known thatscoliosis is apparently inheritedin some families, Schulthessestimating that from 10 to 15per cent, of scolioses are heredi-tary. Congenital defects ofform can be inherited, andwould reasonably lead to sim-ilar forms of scoliosis, while aninherited weak skeleton or adisposition to rickets would notnecessarily lead to a reproduction of the form of scoliosis. There arecases, however, in which the form also seems to be Fig. 9.—Congenital Elevation of theScapula Causing Scoliosis. B. ACQUIRED is to be classed as acquired when the deformity comeson after birth from some cause not apparently congenital, and thisincludes, so far as we know now, the greater number of cases. It maybe said in general that any anatomical or physiological condition whichcauses the spine to be held habitually curved to one side during theperiod of growth is a competent cause of scoliosis, and, although certain SCOLIOSIS CAUSED BY ASYMMETRY. 95 individuals under tiaese conditions will escape permanent bony defor-mity, certain others will acquire a change in the shape of the spinalstructure. The experimental production of scoliosis in animals hasbeen demonstrated and is discussed elsewhere (page 42). The ac-quired varieties of scoliosis may be considered as follows: I. ANATOMICAL OR PHYSIOLOGICAL ASYMMETRIES ELSEWHERETHAN IN THE SPINE. (a) Torticollis,
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