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The spine consists of many small bones; the vertebrae, which are separated from each other by a cushion of cartilage known as the inter-vertebral disc.

Projections from the back of the vertebra enclose a canal through which passes the spinal cord consisting of nerve cells and fibres.

These projections from the back of the vertebra connect with the ones above and below by means of small joints.

Viewed from the side the spine has two S curves, one above the other. The end result, functionally, results in a vertical position and viewed from the front or back the spine is straight.

In the condition known as scoliosis there is a sideways curve of the spine which is complicated by a rotational deformity. In the chest this rotation can affect the ribs and distort the chest cavity.

Once a kink develops in the spine a corresponding tilt must also develop the other way at some other level so as to enable the person to stand upright.

Sometimes scoliosis may be secondary to muscle weakness or paralysis, such as may occur with poliomyelitis.

Sometimes the condition is due to poor posture in the child, but under this condition it is always mild.

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Iatrogenic disease is caused by medical treatment and the more potent and effective remedies we have, the more complications and side effects we get.

Every doctor who prescribes for a patient has to weigh the good effects from his treatment against the likely bad effects.

In most cases, the side effects are rare, so he can prescribe with little risk to his patient.

Sometimes the doctor may be aware of the risks of side effects, yet his patient may be blissfully unaware.

I do not advocate telling every patient about every side effect or the secondary anxiety we cause may be worse than the complaint for which the patient originally consulted us or he might refuse to take the medication and suffer severely from the disease because of fear of rare side effects.

Potent cortisone creams and ointments are freely prescribed for many skin conditions and, if not emptied, the tubes lie around in the cupboard and are often self-prescribed for any subsequent rash.

These strong cortisones should not be used on the face. It has been known since 1972 that they can convert a minor facial rash into a separate condition known as peri-oral dermatitis.

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