The Rapid Cure of Rotary-Lateral 
Curvature of the Spine and other 
Postural Deformities 
By Means of Thorough Development and 
Corrective .Exercises with Heavy Weights. 
BY 
JACOB TESCHNER, M. D., 
NEW YOBK, 
Orthopedic Surgeon to West Side German Dispensary. 
REPRINTED FROM THE 
Neto Merit itteUtcal Journal 
for May 23, 1896. Reprinted from the New York Medical Journal 
for May 23, 1896. 
THE RAPID CURE OF 
ROTARY-LATERAL CURVATURE OF THE SPINE 
AND OTHER POSTURAL DEFORMITIES 
BY MEANS OF THOROUGH DEVELOPMENT 
AND CORRECTIVE EXERCISES WITH HEAVY WEIGHTS* 
JACOB TESCHNER, M. D., 
NEW YORK. 
A paper f read by me before the Orthopaedic Section of 
the New York Academy of Medicine, May 17, 1895, was 
entitled The Treatment of Postural Deformities of the 
Trunk by Means of Rapid and Thorough Physical Devel- 
opment. In that paper I outlined my views concerning 
the more important aetiological factors in the causation of 
these deformities. The plan of treatment devised by me 
was demonstrated by patients, and the cases of nine patients 
were reported, five of whom were presented. The cases 
were: One of very marked one-sided deformity of the sterno- 
costal articulations, cured; two of firmly fixed and severe 
scoliosis, of many years' standing, with firm and resisting 
* Read before the tenth annual meeting of the American Orthopaedic 
Association, held in Buffalo, May 19, 20, and 21, 1896. 
f Annals of Surgery, Philadelphia and London, August, 1895. 
Copyright, 1896, by D. Appleton and Company. 2 
ROTARY-LATERAL CURVATURE OF THE SPINE. 
bony and ligamentous changes, markedly improved; and 
six of ordinary rotary-lateral curvature of the spine, three 
of which were partially fixed, all cured. These cases were 
treated for different periods from six weeks to four months. 
Since October last I have discharged twelve patients as 
cured. Such uniformly good results as I have obtained in 
a class of cases the treatment of which up to the present 
time has been, at best, very unsatisfactory in the hands of 
orthopaedic surgeons generally, suffice to justify me in 
maintaining the curability of these deformities. Hence the 
title of this paper. 
I shall present to you the salient points of the treat- 
ment, and demonstrate to you the character of the work. 
I shall also show you the different immediate effects of the 
corrective exercises upon the trunk as a whole, and espe- 
cially upon the vertebral column. 
Believing that the most important aetiological factor in 
the causation of these deformities is a weakened or rudi- 
mentary condition of the muscular systems generally, or of 
certain muscular groups in particular, I hold that all the 
muscles should be developed, educated, and strengthened 
to their fullest extent, not only in those cases where the 
tendencies to deformities are known to exist, but also 
where deformities, whether habitual or fixed, are present, so 
that they may be cured, improved, or prevented from be- 
coming worse. 
I shall quote from my former paper: 
" All orthopaedists are agreed that exercises, when 
properly given, are beneficial; but the degree of benefit 
must necessarily depend upon the muscular ability and the 
strength and the will of the individual patient to correct, 
or to partially correct, a faulty attitude or deformity. 
" In considering the question of muscular development, 
I wish to state that I have renounced and discontinued all ROTARY-LATERAL CURVATURE OF THE SPINE. 
3 
supporting and immobilizing appliances, as described in 
my paper,* in any and all cases which I consider amenable 
to treatment. 
" The objection to all supporting appliances is that each 
and every one will, to a greater or less extent, interfere 
with the mobility, and in that manner deprive the back, 
chest, and abdominal muscles of that perfect freedom of 
action which is a necessary and powerful adjunct in the 
successful treatment by gymnastics. In the treatment of 
deformities the aim is and has been to correct the devia- 
tions from the normal by such exercises as will educate the 
different groups of muscles to sufficient and proper exer- 
tion to enable the patient to assume as nearly as possible a 
normal attitude. This muscular education is dependent 
upon strength and development, without both of which we 
must largely fail to obtain that proper and vigorous muscu- 
lar action upon which any beneficial results from corrective 
exercises must depend. Therefore it is necessary and im- 
perative in all cases which require or are amenable to treat- 
ment to attain the highest type of development possible of 
the entire body, to render the spine mobile in all directions, 
and also to develop the full strength of each patient. In- 
dividual work only can accomplish this end, because it is 
of the highest importance to carefully watch every move- 
ment of the patient, and to immediately correct any and all 
errors in attitude, deportment, or exercise." 
" The important points to be observed in the develop- 
ment of strength and muscle are correct attitude, ease and 
grace and rhythm of motion, and automatic and independ- 
ent and full action of only those groups of muscles which 
* Observations on the Rotary-Lateral Curvature of the Spine, with 
Special Reference to the JEtiology and Treatment. Read before the Sur- 
gical Section of the Pan-American Medical Congress, at Washington, 
D. C., September 5, 1893. Medical Record, December 16, 1893. 4 
ROTARY-LATERAL CURVATURE OF THE SPINE. 
are called into play by the performance of each separate 
exercise, and each group of muscles automatically exer- 
cised until it is thoroughly tired. No muscle can be prop- 
erly developed unless it is tired by frequent and uninter- 
rupted automatic contractions and relaxations. 
" All exercises with light weights should be executed in 
a closely fitting jersey suit before a mirror, so that the pa- 
tients can hold themselves in the proper position while 
going through the different movements. By doing this 
they can see when the position is faulty, either by reason 
of a sagging of the trunk or through the lack of co-ordina- 
tion of all those muscles which are to remain fixed while 
certain groups are in action, and they can correct their 
faults. It also materially assists in the acquisition of grace 
and ease in working automatically. Exercise in this man- 
ner brings about a forced and habitually corrected pose and 
carriage, while the strength and muscles necessary to main- 
tain a correct position are being developed. 
"Taking the standpoint that (1) lack of strength and 
lack of muscular development, (2) habitual faulty position 
with superimposed weight, and (3) lack of co ordinating 
power or lack of muscular control are the more potent 
{etiological factors in producing deformities, it is and has 
been my aim-and I believe that I have succeeded-in 
correcting deformities by reversing these conditions : that 
is, (1) by developing the muscles and their strength; (2) 
by acquiring an habitually corrected position with super- 
imposed weight; and (3) by educating all the muscles to 
proper co-ordination and to complete control. 
" A pair of dumb-bells weighing from half a pound to 
five pounds are used in a series of twenty-six exercises for 
the development of the muscles." 
In addition to these development exercises, I give the 
patients work with heavy bars and bells at each visit to my ROTARY-LATERAL CURVATURE OF TIIE SPINE. 
5 
office. The weight of the bars and bells and the number 
of times that each heavy weight or pair of weights is 
handled, depend upon the strength, capacity, and upon the 
endurance of the individual. It is my practice to put each 
patient to his or her individual limit of work at each visit, 
and that limit is invariably extended at each succeeding 
visit, unless the patient is indisposed. The strength and 
endurance, as shown by the amount of weight handled, and 
the number of times each weight and set of weights are han- 
dled, increases very decidedly in every case from one visit to 
another. This increase is largely dependent upon correct- 
ness of posture and precision in the work. This is a mat- 
ter of record in all my cases, as I keep a tabulated state- 
ment of all the work, designating the weights used and the 
exact number of times each exercise has been performed. 
This heavy work develops the strength to the fullest 
xtent, and it is by means of this work that I have been 
enabled to correct severe deformities even where bony 
and ligamentous changes and marked rotation were 
present. This is my corrective work, which I will dem- 
onstrate : 
Bells, weighing from five to eighty pounds each, and 
steel bars and bar bells, weighing from twenty-six to over 
one hundred and eleven pounds, are used in different ways. 
Bells are pushed from the shoulders above the head alternate- 
by as often as the patient can. 
" The patient is instructed to swing a heavy bell with 
one hand from the floor above the head and down again, 
the elbow and wrist being fixed, and the motion repeated 
as often as possible in a systematic manner; then with the 
other hand the same number of times, and later with both. 
This exerts all the extensor muscles from the toes to the 
head in rapid succession. 
" When a heavy bell is pushed or swung above the head 6 
ROTARY-LATERAL CURVATURE OF THE SPINE. 
on the side opposite the scoliosis, the action of the back 
muscles, to sustain the weight and equilibrium, is such as 
to cause the curved spine to approximate a straight line. 
A similar result is produced when a heavy weight is held 
by the side of the erect body on the scoliotic side, the arm 
being at full length. 
" When a heavy bar is raised above the head with both 
hands, the patient must fix the eyes upon the middle of the 
bar to maintain an equilibrium. This necessitates the bend- 
ing of the head backward, the straightening and hyper- 
extending of the spine, and consequently correcting a faulty 
position with a weight superimposed. The heavier the 
weight put above the head, whether with one hand or with 
two, the more the patient must exert himself or herself to 
attain and maintain a correct or an improved attitude in 
order to sustain the equilibrium. (By an improved atti- 
tude I mean the greatest amount of correction of the devi- 
ation of the spine that the fixation of a deformity will 
allow of.) Hence, the greater the weight, the more forci- 
ble the actions of the muscles become, and the greater the 
temporary reduction of a deformity. It is by means of 
frequent and forcible temporary reductions of deformities, 
by voluntary muscular action, that we can hope to improve, 
and do improve, those cases which are amenable to any 
form of active treatment. 
"When a patient, lying supine upon the floor, raises a 
heavy bar above the head so that the arms are perpendicu- 
lar to the floor, the weight of the bar, the position and 
weight of the body, and the action of the muscles tend to 
broaden the entire back and shoulders, and a slow down- 
ward movement tends to.widen the entire chest, and most 
markedly at the shoulders. The frequent repetition of the 
upward and downward movement plays an important part 
in the rapid development of the chest and back. Pushing ROTARY-LATERAL CURVATURE OF THE SPINE. 
7 
the bells above the head, swinging them with each hand 
separately and with both hands together, raising a bar above 
the head, standing and lying down, and the exercises before 
enumerated, constitute one day's work. 
"As the amount of work performed by a patient depends 
upon the last previous record of that patient, that record 
must be improved upon at each succeeding visit, unless there 
be a good and sufficient reason to the contrary. Most pa- 
tients can well stand three treatments a week. In mild, 
habitual cases improvement in deportment is noticed by 
the patients' relatives and friends and by the patients them- 
selves within the first two weeks. In those cases two 
months' treatment usually suffice to effect a complete cure. 
In the more severe cases it is not and can not be expected 
to attain such rapid results, but a certain appreciable im- 
provement is effected, and the amount of improvement de 
pends upon the persistent continuance of the treatment. 
Where there is a fixed rotation of long standing, with bony 
and ligamentous changes, the prospects are not so good ; 
but even in those cases I am sure that I have shown con- 
siderable improvement in their conditions. 
" Patients are not permitted to wear supports of any 
kind, not even corsets. They should not exercise until at 
least two hours after a meal, nor when menstruating. 
The general health is improved by the exercises ; the pa- 
tients gain in height and weight. The girths and breadth 
measurements, chest depth, strength tests, and lung capa- 
city are generally increased, and the depth of the abdomen 
is usually decreased. In some cases, especially those of 
undersized patients, the increase in height is very rapid, 
and it is certainly more than the increase by ordinary 
growth. There were marked cases of flat-foot which were 
benefited, as will be seen by reference to the charts. The 8 
ROTARY-LATERAL CURVATURE OF THE SPINE. 
flat feet became shorter through the exercises by the in- 
crease in depth of the inner arches. 
" This system of work should only be applied by the 
physician, and he must himself have been trained to the 
work to intelligently guide those whom he seeks to benefit. 
The work must be careful, systematic, and regular. Per- 
functory work will not do." 
To justify the title of this paper-i. e., The Rapid Cure, 
etc.-I point to the results that I have attained (of twenty- 
one patients treated, nineteen discharged cured, and two 
very much improved when treatment ceased), and I wish 
to report one case (with photographs) of marked deformity 
Fig. 1.-Before treatment, February 
24, 1896. 
Fig. 2.-March 25, 1896, after three 
weeks of actual treatment. 
in which an almost complete obliteration of that deformity 
was obtained after three weeks of treatment. 
Several of the gentlemen present saw the patient at a ROTARY-LATERAL CURVATURE OF THE SPINE. 
9 
meeting of the Metropolitan Medical Society of New York, 
at my residence, in March last. 
B. B., aged fifteen years, February 12, 1896. 
More than a year ago the mother noticed that the patient 
stooped, and attributed that attitude to carelessness. About 
two months ago the mother noticed that the left hip was 
Fig. 3.-Profile showing eminence 
at upper portion indicative of ro- 
tation, February 24, 1896. 
Fig. 4.-March 25, 1896, after three 
weeks of actual treatment, show- 
ing disappearance of rotation. 
much larger and higher than the other. For the past few 
weeks the patient has complained of severe hackache, so that 
she was uncomfortable in a sitting posture. The patient was 
examined by Dr. I. Oppenheimer, who referred her to me for 
treatment. 10 
ROTARY-LATERAL CURVATURE OF THE SPINE. 
Her menstruation is regular, but she complains of severe 
dysmenorrhoea, which compels her to take to her bed for a 
few days at the appearance of each menstrual period. 
Examination.-Patient is intensely anaemic. There is a 
marked lumbar C curve to the right, the greatest deviation 
being an inch from the median line (plumb line). Both 
scapulas are prominent, the right more than the left. Ilio- 
costal curve well marked on the right side, obliterated on the 
left. Patient has marked abduction and pronation of the 
right foot, with occasional pain. There is no spasm. Wears 
the sole and heel down on the inside. 
Fig. 5.-Showing the contracted 
chest and prominence of the left 
hip, February 24, 1896. 
Fig. 6.-Showing improvement in 
the conformation < f the chest 
and equalization of the ilio-costal 
curves, March 25,1896. 
Chicken breast; large depression below clavicles; stoop 
shoulderswell marked; right shoulder higher than the left, 
and head very poorly poised. Patient has about ten degrees 
of rotation. ROTARY-LATERAL CURVATURE OF THE SPINE. 
11 
Ordered the shoe of the right foot to be built up a quarter 
of an inch on the inside of the sole, and advised developmen- 
tal and corrective treatment. 
February 21fth.-Patient menstruated last week with great 
suffering for about ten days. She begins treatment to-day ; 
is extremely weak and very awkward. (She fainted twice 
while being photographed.) 
March 11th.-Examination of the patient after her eighth 
treatment (a little less than three weeks after treatment was 
begun) shows the deformity almost obliterated (see photo- 
graphs). There is no deviation of the spine, the scapulae are 
not prominent, the ilio-costal curves are about equalized, the 
shoulders are of equal height, the rotation of the spine has 
disappeared, and the right foot is no longer abducted. 
18th.-Patient menstruated last week without the slightest 
pain, recovering fully in four days. 
April 18th.-Patient began to menstruate on April 11th, 
and the flow continued until the 15th, normally and without 
pain. 
The patient was discharged as completely cured on May 
2d, after twenty-six treatments. f 
In closing T wish to call your attention to certain facts 
which I have observed in the treatment of my cases, and 
which should commend this system to the preference of 
all other methods. 
1. It is rapid-improvement being noticed by the pa- 
tients, their relatives, and myself within a week or ten days 
after treatment has begun. 
2. The improvement in general health and the increase 
of weight. 
3. The wholesome effect upon the nervous system by 
the cultivation of muscular precision and endurance. 
4. The marked increase in the lung capacity. 
5. The beneficial effect upon the heart's action, as 
shown by the diminished frequency of the pulse and the 12 
ROTARY-LATERAL CURVATURE OF THE SPINE. 
increase of pulse pressure after each treatment, as shown 
by Basch's sphygmomanometer. 
6. That all the patients continue to improve generally 
and muscularly long after active treatment has ceased. 
Tn defending this heavy work against the adverse criti- 
cisms of those who might condemn it, either from their 
hearsay knowledge of its baneful effects or from their own 
observations of athletes who have been " trained down" 
for special work, I cite the following facts, viz. : 
The general health has been good. The heart's action 
has become more vigorous, as shown by the diminished 
frequency of the pulse and the increased pressure indicated 
by Basch's sphygmomanometer. 
The weights, chest capacities, chest depths, girths, 
breadths, and strength tests are generally increased, the 
abdominal depths are decreased, and the feet, the founda- 
tion of correct posture, are improved, inasmuch as all flat 
feet become shorter and the normal feet grow. 
All this should prove that they are not overworked. 
134 East Sixty-first Street. The New York Medical Journal. 
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