The causes of this lateral curvature of the spine, and consequent bulging out of the ribs that you have just now described, arise either from delicacy of constitution, from the want of proper exercise, from too much learning, or from too little play, or from not sufficient or proper nourishment for a rapidly-growing body. I am happy to say that such a case, by judicious treatment, can generally be cured--namely, by gymnastic exercises, such as the hand-swing, the fly-pole, the patent parlour gymnasium, the chest-expander, the skipping rope, the swimming bath; all sorts of out-door games, such as croquet, archery, &c.; by plenty of good nourishment, by making her a child of Nature, by letting her almost live in the open air, and by throwing books to the winds. But let me strongly urge you not, unless ordered by an experienced surgeon, to allow any mechanical restraints or appliances to be used. If she be made strong, the muscles themselves will pull both the spine and the ribs into their proper places, more especially if judicious games and exercises (as I have before advised), and other treatment of a strengthening and bracing nature, which a medical man will indicate to you, be enjoined. Mechanical appliances will, if not judiciously applied, and in a proper case, waste away the muscles, and will thus increase the mischief; if they cause the ribs to be pushed in in one place, they will bulge them out in another, until, instead of being one, there will be a series of deformities. No, the giving of strength and the judicious exercising of the muscles are, for a lateral curvature of the spine and the consequent bulging out of one side of the ribs, the proper remedies, and, in the majority of cases, are most effectual, and quite sufficient for the purpose. I think it well to strongly impress upon a mother's mind the great importance of early treatment. If the above advice be followed, every curvature in the beginning might be cured. Cases of several years' standing might, with judicious treatment, be wonderfully relieved. Bear in mind, then, that if the girl is to be made straight, she is first of all to be made strong; the latter, together with the proper exercises of the muscles, will lead to the former; and the _earlier_ a medical man takes it in hand, the more rapid, the more certain, and the more effectual will be the cure. An inveterate, long-continued, and neglected case of curvature of the spine and bulging out of the ribs on one side might require mechanical appliances, but such a case can only be decided on by an experienced surgeon, who ought always, _in the first place_, to be consulted. 368. _Is a slight spitting of blood to be looked upon as a dangerous symptom_?