A treatise on orthopedic surgery . diameter at ^ Eoberts, Journal American Medical Association, Oct. 3, 1908.^Martirene, Kevue clOrthopeclie, May, 1903.^Klar, Zeits. f. Orth. Chir., Bd. Heft 2, 1906.*Zeits. f. Orth. CMr., Band Heft 4, 1908. ^Journal American Medical Association, September 11, 1897, and May2, 1903. DEFORMITIES OF THE SPINE. 235 the same level; hence the lower index, the longer and flatter,more bellows-like the chest. Embryo 105-115 At birth 101 Under 2 years 94 ? 3-7 years 85 14-18 years 80 Adult 72 Treatment.—The treatment of the so-called flat chest is simi-lar to
A treatise on orthopedic surgery . diameter at ^ Eoberts, Journal American Medical Association, Oct. 3, 1908.^Martirene, Kevue clOrthopeclie, May, 1903.^Klar, Zeits. f. Orth. Chir., Bd. Heft 2, 1906.*Zeits. f. Orth. CMr., Band Heft 4, 1908. ^Journal American Medical Association, September 11, 1897, and May2, 1903. DEFORMITIES OF THE SPINE. 235 the same level; hence the lower index, the longer and flatter,more bellows-like the chest. Embryo 105-115 At birth 101 Under 2 years 94 ? 3-7 years 85 14-18 years 80 Adult 72 Treatment.—The treatment of the so-called flat chest is simi-lar to that of the round shoulders, with which it is combined—that is, by exercises conducted with the special object of improv-ing the strength of the muscles of the back and increasing theexpansion of the upper part of the chest. The importance ofcorrecting the deformity, which interferes with the proper ex-pansion of the lungs and thus predisposes to disease, should beevident. Pigeon Chest Synonym.—Pectus carinatum. Fig. General rhachitic distortious and pigeon chest. 236 OETHOPEDIC SUEGEEY. The i3igeoii, or keel-shaped, chest resembles the quadrupedaltype in that the anteroposterior is increased at the expense ofthe lateral diameter. The sternum is thrust forward and down-ward like the keel of a boat, the lateral compression being mostmarked at the junction of the ribs and the cartilages. Thisdeformity is almost always acquired (Fig. 176) ; it is usuallyan effect of rhachitis, and it is described under that may be induced by obstruction of respiration caused by en-larged tonsils and the like, if this is present at an early age. Itmay be a secondary effect of the sinking forward and downwardof the uj)per half of the trunk, as in Potts disease. Treatment.—The treatment of secondary deformity would beincluded in the treatment of the affection of which it is theresult. Manipulation, massage, and breathing exercises may beemployed in the treatment of simple pig
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