THE FORMATION of a dense layer of fibrous tissue in the pleural space always results in some degree of scoliosis. When this condition of fibrothorax originates in adult life, the scoliosis is seldom sufficiently severe to constitute a disability; decortication. when it is done, is to improve respiratory function or to cure chronic empyema. In children the growth of the spine introduces another factor which leads to a progressive deformity, the eventual extent of which depends on the degree of fixation of the chest wall and the amount of growth which takes place before the condition is corrected or adult stature reached.
The extreme degree of thoracogenic scoliosis is seen in persons in whom chronic empyema has developed in infancy. The ribs remain infantile in type, crowded together and sometimes fused to each other; they come to resemble the spokes of a wheel, of which the hub is in the