1° CYPHOSIS.

Treatment of a patient of the slender type, suffering, after the diagnosis of the rheumatologist, from cyphosis dorsal

The patient was seemingly free from lordosis and his cyphosis was important and so stiff that his arms could barely raise horizontally. He was in a corset which started to cause wounds because of the constant progress of the aggravation.

As no « extension » exercise was possible and no pressure had any effect whatsoever, I placed him in decubitus position. To have him lay his entire back flat on the floor, I tried to press his shoulders. To make things easier, I asked him to put his hands to his shoulders and strived to bring his wrists down to the ground and his elbows close to his body. Although,because of the severe stiffness of the scapular belt, this correction was imperceptible, I saw a lumbar lordosis appear, which was getting more marked when I insisted on the scapulo-dorsal realignment. To prevent this back curve, I flexed his knees on his chest, with his chin close to his neck, by exerting pressures on his wrists, his knees and his chin.

This position, I will call « posture », was all the more painful in proportion as I was exerting more intense pressures ; defences, often unconscious, arose from them. Little by little the postures became bearable and afterwards I added the stretching of the ilio-tibial muscles and of the adductors by keeping the legs straightened and open, the thighs being flexed.

I saw, as the « extensors » were becoming more flexible, the back realign itself and the patient said he had grown « taller » since he couldn't see his full picture in the mirror.

Thus, contrary to what I had been taught, despite the advanced age of the patient and his high level of
dysmorphism, the misalignment was corrected, and, this was due to the stretching of the posterior muscles. The realignment of the shoulders excepted, I had treated this cyphosis like a total lordosis and the dorsal stiffness had disappeared along with the one of the shoulders.

The articular stiffness of the back hadn't had to exist. this gave prominence to the following facts ;

1° The realignment of the back is achieved through the realignment of the scapular belt, i.e. through the external rotation of the arms in adduction. The lumbar lordosis arises from it.

2° The lumbar lordosis is corrected by the backward tilt of the pelvis, i.e. through the flexion of the thighs. The cervical lordosis arises from it.

3° The cervical lordosis is corrected by the retreat of the chin.

The mechanism of these repercussions can be explained like this.

The realignment of the dorsal curvature shortens the spinal muscles at this level. As a consequence, these muscles sustain a pull at their ends : the lower end of the cervical segment and the upper end of the lumbar segment. The sacrum and the occiput are attracted towards each other. The dorsal cyphosis is the result of the attitude
of the scapular belt (and it would be better called « scapular cyphosis »), the latter attitude is the consequence of the stiffness of the spinal muscles

The notion of asthenia and weakness, in the face of weight, as being at the origin of cyphosis, is therefore a mistake.

As a consequence the treatment based on that idea is the opposite of what it should be.
WHAT MUST BE DONE :
Relax the upper fascicles of the trapezia and the internal rotators of the arms, the joints of the dorsal vertebrae must not be touched.

WHAT MUST BE DONE

Stretch the spinal muscles over their entire surfaces and do not

- tone them up and do not shorten them through backward flexions of the back and of the head with counterweight,

- or try to stretch them exclusively at the level of the segment which, in the stand-up position, is lordotic.

What must be done :
Act only parallel to the axis (vertical) of the rachis, i.e. stretch it
And not
Perpendicularly to that axis by trying to depress the convexities and protrude the concavities, on a collapsed spinal column.

Thinking again about the vertebral attitude imposed by the stiffness of the muscles of the canals, an important notion appears : unlike from what is taught, the rachis is shrunk behind its tranversal axis and, on the contrary, stretched before this axis. The common vertebral ligament is therefore relaxed.

Thus the entire vertebral strain, behind the axis in question is confirmed to be the remedy of vertebral misalignments and we will see afterwards, that the postures realize it perfectly.

2° LUMBAR LORDOSIS..

Treatment of a lumbar lordosis diagnosis confirmed by the examination of the patient in stand-up position

After sitting the patient on the floor, his knees flexed at shoulder level, I saw he was shrunk over himself.
Lumbar lordosis was making way for a cyphosis, spread to the lower part of the back, but it had been transferred to the cervico-dorsal region. It was growing bigger and spreading to the last dorsal vertebrae if the shoulders were corrected by the position of the hands to the shoulders(described earlier). All theses curvatures were realigned through a a vertical pull on his head, performed by pushing the chin towards the neck.
I have noticed that it is always the case with the neck and lumbs in that sitting position. But the extreme shrinking of the upper fascicles of the trapezia and internal rotators of the arm doesn't always allow to put the hands to the shoulders. In this instance, the back stays in cyphosis and the vertical pull on the occiput can only lessen the convexity.

This observation, which confirms the conclusions of the former observation, the same postures were applied to this case with the same success.
It clearly confirms the link between the correction of the cyphosis and the scapular and vertebral attitudes:
In the first instance, the dorsal correction(operated through the scapular belt) caused a lumbar lordosis ;
In the second instance, the correction of the lordosis generated a cyphosis (owed to the forward elevation of the shoulders) ;
In both instances, the head was moving forward and the nape of the neck was falling in. Both were corrected by the same postures.

I insist therefore on the necessity of acting simultaneously on the scapular belt and on the ends of the rachis

3° EXAGGERATION OF CURVATURES

Treatment of a cypho-lordosis, diagnostis confirmed by the examination of the patient in standing position.

The sitting attitude, hands to shoulders, described in the second observation, showed up, in lieu of an exaggeration of the diagnosed dorsal and lumbar curvatures, an inversion of these curvatures. The back was only in cyphosis when the scapular correction was ignored, the arms falling freely.

This observation, confirming the previous one, the same treatment, applied again to this patient, was also corrective.

The word « cyphosis » shouldn't be applied to these instances but to those, extremely rare any way, which mark a more advanced stage of the misalignment. The stiffness of the muscles of the scapular belt is then so severe that it prevents the dorsal realignment (it is the case described in the first observation). Still it would be better to say « scapular cyphosis ».

I only experienced a real cyphosis, i.e. including a flexion of the dorsal segment , in a patient whose dorsal vertebrae were cuneiform. The X-ray highlighted the height, bigger at the front then at the rear, of the vertebral bodies. This cyphosis was accompanied and exaggerated by lumbar and cervical lordosis. The strain of the spinal muscles has led to the result I had heralded : because of the cuneiform vertebrae, the back is still convex during the forward flexion but standing or sitting in upright position, the cyphosis is corrected.

4° TOTAL LORDOSIS

Treatment of a total lordosis, coexisting with a sternal curve, a hypertrophy of the lower region of the thorax, detached shoulder blades and a bulging belly.

While I was again applying the classical method, I had drawn up for this patient a set of exercises tackling each distortion separately.
Believing I would realign lordosis by strengthening the abdominal wall, I had beefed it up strongly through the following exercises from the decubitus :

- the forward flexions of the trunk ;

- the elevations of the lower limbs from 45 degrees, the back being rounded by the rest on
the elbows
During those exercises, the shoulders were rising. In standing position, despite the strong tonicity of the abdominal strap, the belly was still forward whereas the lordosis had worsened. I sought then to realign the back, without beefing up the abdominal wall any more and tried the forward flexions in the standing attitude.The lordosis was then correcting itself in the lumbar and dorsal regions, but remained unchanged in the nape of the neck, while the shoulder blades went further apart and it was impossible to bring the shoulders down.

The capital suspensions failed to correct that poor rachis either.

The sternum being depressed, I had superior costal inspirations carried out but, while the transverse was deepening, the last ribs went apart and the epigastrium projected forward, bringing to light an enormous stomach, whereas the shoulders were raising in a forward motion and the head was moving forward and tended to tip backwards, forming a concave triangle under the nape of the neck.

It was impossible to have the sus-ombilical part of the transverse muscle contracted, nor to bring down the shoulders during the contraction of this muscle. I tried the other respiratory types, which had the same effects ; Unsuccessful were also upper costal inspirations in sitting position, the arms open crosswise and blocked so that the pectoralis major could be set in motion and raise the sternum.

Only on the day when I abandoned those classical exercises to perform, through postures, the stretching of the spinal muscles, of the upper fascicles of the trapezia, of the illio-tibial muscles and of the adductors, and where I saw the improvement underway.

I resumed the abdominal exercises, but in decubitus position, the hands to the shoulders, elbows close to the body, wrists on the floor, the chin kept near the neck, the transverse muscle being contracted at the maximum ! The patient was performing alternate movements of the lower limbs from the ground. The flattening of the abdomen, in the standing position followed.

This confirms : that the forward raise of the shoulders is the effect of the shrinking of the spinal muscles and as a consequence the realignment of the rachis alone, because it triggers a pull on the muscles of the canals, worsens the scapular belt. Reciprocally the sole correction of the shoulders provokes the inversion of the dorsal segment and the exaggeration of the adjacent segments.

No exercise is therefore efficient unless it tackles simultaneously the scapular belt and the rachis.

In addition this proves that :

1° the thoracic shape is linked to the rachidian attitude. One understands the importance of the mistake made in prescribing, to improve the thoracic cage, multiple respiratory exercises performed on free extension movements.

Res^piratory exercises are only beneficial if they are performed on the entire strain of the rachis and on the correction of the scapular belt ;

2° the strength of the abdominal muscles doesn't correct a bulging belly if it is not realized by exercises performed in an attitude aiming to the total strain of the spinal muscles and of the upper fascicles of the trapezia and on the contraction of the transverse muscle, i.e. the shrinking of the abdominal muscles is necessary to the improvement of the static and to the normalisation of the morphology.

5° THE INVERSION OF CURVATURES

Observation of a diagnosed case, after the examination of the patient in standing position :
Inversion of curvatures.

When I watched the patient undressing, I saw he was flexing his knees and was arching himself backwards whenever he had to raise his arms with a clear exaggeration of the curvatures as a result, which made way for the diagnosed inversion.
The latter came about only in standing still position with his arms falling.

I enivitably checked, in any case whatsoever, that effect of the raise of the arms.

The same postures brought the rachis back to normal.

This demonstrates that the examination of the patient in standing position to pose a diagnosis, can only lead to errors.

6° CONCLUSION

From these observations it appears that, regardless of the cyphosis, and of the level or evidence of the lordosis, the simultaneous strain of the upper fascicles of the trapezia and of the spinal muscles over their entire surface, corrects the different misalignments in the antero-posterior direction.

All the cases of misalignments, in that direction, include therefore a shrinking of the spinal muscles and their strain is the treatment.

The examination pf the patient in standing position designed to determine the misalignment of each segment, with a view to treatment, is unimportant, not to mention it leads to a false diagnosis. That examination is only useful(as well as the measurements that are taken) when it comes to checking the progress in the course of the treatment. But then, the observation of the patient,in the event the misalignment is not showing, must be included :

In his free movements, when he is « compensating » while dressing and undressing ;

In the static exercises, for example, when he stands to attention;

In posture, which is the only means to gauge the stiffness of the muscles of the canals and of the scapular belt.

Frequently the position of the hands to the shoulders can't be correctly performed. It will trigger a more or less considerable lordosis, and the flexion of the thighs will provoke a variable raise of the chin. The practitioner who « is handling » the patient will put « his defences » to the test. In the end, we will see afterwards the entire interest expressed by the postures and the importance of the practitioner's role.

B LATERAL MISALIGNMENTS

Treatment of an S-shaped scoliosis

Having had the patient perform an asymmetrical exercise and observing him attentively from behind and from the side, I noticed that, if the lateral misalignment corrected itself properly, it was to the benefit of a lordosis. The latter is explained by the lateral pull exerted by the asymmetrical exercise, on the muscles of the canals. Being stiff they recover in the antero-posterior direction, what they give laterally.

The symmetrical strain of the spinal muscles in their entire length, performed at the same time as the correction of the shoulders, by the postures, provoked on the contrary, the realignment wished, and the X-ray taken in the course of the treatment, will show an improvement of the lumbar and cervical regions (the first to be affected by the postures the pull of which applies to the end of the rachis)

This shows : that the stiffness of the spinal muscles (the lordosis of which, visible or not), is at the origin of the scoliosis and at the origin of the misalignments in the antero-postérior direction.

Besides, you only need to think about the classical means in current use for a long time to determine the severity of a scoliosis and which consists of, the patient in standing position, a flexion of the trunk forward. If, in this attitude, the scoliosis is realigned, it is of the first degree, i.e soft.

Doesn't this show clearly that, as long as the spinal muscles are still stretchable, the symmetrical pull, triggered on them by that flexion, is enough to stamp out what their light shrinking has provoked, and shouldn't this total and symmetrical pull of the spinal muscles be at the base of any sensible treatment !

TREATMENT of a funnel-like thorax.

A child, very sickly, aged 8 , after 2 years of classical gymnastics, still showed, after the notes of the specialized surgeon, a funnel-like thorax and a big belly.

In the face of the irreducible look of the enormous distortion, the surgeon decided on the operation but on the insistence of one of my colleagues, convinced of my opinions, the operation was postponed: a deadline of two months was given to attempt again to bring that thorax back to normal by an appropriate gymnastics.

The postures were applied to the patient on the basis of two sessions per week and alternate movements of the lower limbs performed on the strain of the rachis and the contraction of the transverse muscle.

Later on, in that attitude,inspirations of upper costal type were added.

Not only was the operation avoided, but the child is now normal.

This confirms the conclusions of IV Observation, especially :

- that the thoracic shape depends on the one of the rachis and the scapular attitude, thus the static position influences the morphology ;

-and that consequently the respiratory exercises must only be performed on the strain of the spinal muscles, i.e. during the postures.

3° About respiratory insufficiency

This idiom sounds inaccurate to me and doesn't mean much. If this equals to the confinement of the thoracic cage, I noticed it was rare to see a narrow chest in all its diameters. In this instance the only thing to do is to teach the patient how to slow down, how to push the two strokes of respiration to the maximum and how to practice the three respiratory types.

But actually, we always have to do with an alteration of the shape of the thorax some diameters of which are overdeveloped compared with the others ; In many cases the respiratory capability is important. The rachidian attitude is always faulty. In this instance,respiratory gymnastics, mentioned earlier is bound to increase the distortion. (Observations IV and VII).

D OTHER EFFECTS OF THE LORDOSIS

A. On the Rachis

1° Cases of vertebral rheumatisms

One of my parents, treated for more than 20 years for vertebral rheumatism and I persuaded him, on the sincerity of his bent look, that he was actually suffering from a lordosis, proved his confidence (or his dispair) to me by undergoing my therapy. One session per week of straining the spinal mucles managed after three months to eradicate his « rheumatisms ».

2° A young lady suffering from « vertebral rheumatisms »,

had ben wearing since 1940, after the prescription of a specialist she had consulted at that time, an orthopaedic corset. But her condition had not improved by any means .

The treatment in Aix didn't bring any change. Early in 1949, I started the treatment on the basis of two weekly sessions. Two months later, after the pains had disappeared, she could get rid of her corset. Her general condition has ever since extraordinarily improved.It must also be pointed out that the morphology, which didn't reveal any vertebral misalignment though, has gained a lot.

3° A patient among my friends whose lumbar pains were attributed to rheumatisms and whose X-ray showed a vertebral decalcification with bone spurs and a tear of the common vertebral anterior ligament, still showed a well marked curve of the tenth and eleventh dorsal vertebrae.

The remedies were totally inefficient, I thought that the pain came from the curve of those two vertebrae.
So it seemed to me that only « chiropractic »was capable of remedying this and I advised her that to be treated by a specialist. This resulted in an aggravation of the pains, the patient went to see a rheumatologist who immobilized her in an orthopaedic corset. Since no improvement had followed, her general practitioner prescribed a treatment in Dax,but it had no effect.

It is at that moment, sure of my method, that I proposed her to deal with her case . Despite the apparent absence of lordosis,I performed postures, aiming, not only to strain the muscles of the foramina, but also to shrink the common vertebral anterior ligament .

After two months the improvement was so noticeable that the corset was no longer necessary for the standing position ; the pains had disappeared. As to the vertebral curve, it had become imperceptible.

This demonstrates not only :

that attribution of vertebral pains to « rheumatisms » is an error. They are caused by the shrinking of the spinal muscles and the lesion of the common vertebral anterior ligament ;

But even though that muscular and ligamentary behaviour can exist without the appearance of a lordosis or a misalignment or that they are so light that the examination can barely uncover them.

The postures are the only means to make sure of them ; besides, they are capable of reducing subluxations which« chiropractic » can't remedy.

This fact is important ; it forces us to revise the idea we had imagined of the evolution of misalignments. Cases considered to be minor sometimes conceal a more serious muscular stiffness than big dysmorphisms and deserve to be treated with as much attention.

It is therefore a mistake to have patients that only have an « astenic attitude » practice gymnastics other than medical.

B. About limbs

1° Case of Arthritis in the shoulders. .

The patient aged 55 had been suffering for 5 years from stiffness in the arms and had been particularly suffering from the left shoulder.

During his observation in hospital, 2 years ago, the X-rays of the rachis and the shoulders, and a wealth of analyses, didn't show anything whatsoever.

The iodo-sulphureous injections, the treatment in Dax, the mecchanotherapy, massage, which were performed in turns, didn't bring any kind of improvement.

As I was examining him in standing position, I saw that the vertebral curvatures all looked blotted out ; the cervical stiffness was striking. He could not turn his head and had to turn round his whole body to look right and left.

In decubitus position, the position of the hands to the shoulders was very imperfect and painful, particularly on the left. It provoked an enormous back curve, spread as far as the level of the shoulder blades and his head tilted backwards.

In spite of the torture caused by the postures, the patient had the courage to undergo them and found himself quickly relieved.

This shows that the behaviour of the muscles of the canals reacts on the joints of the limbs and that attribution of arthritis to « rheumatisms » is a mistake.

2° Case of Sciatic Neuralgia.

The patient had experienced the first severe crisis ten years ago.
His neuralgia became chronic and didn't give in to any therapy : the calcium, sulphur and iodine injections , applying heat, the electrotherapy, penicillin were in turns tried but without success ; In May 1948 the patient was X-rayed and the image showed a discal pinch on the left, between the fourth and the fifth lumbar vertebrae. The « chiropractic » was thus applied but the sessions were so hard and caused such an aggravation that the patient gave up the treatment after twelve manipulations whereas another eighteen manipulations were prescribed again to him.

From the first session of postures, a noticeable relief was felt and the patient could sleep and even walk for a few minutes. After eight sessions, the X-ray showed the vertebral realignment.

This shows that the vertebral or discal subluxations, even of traumatic origin, include a retraction of the muscles of the canals. It is therefore an error to manipulate the joints which are maintained in a vicious attitude by the muscular spasms. Only the muscular strain can remedy this.

3° Treatment of a lordosis coexisting with a Genu-Valgus.

I was amazed to see the genu-valgus correct itself whereas no exercise was designed for it in particular.

4° Treatment of Static Scholiosis.

I have seen a lot of children, whose lower limbs even up in the course of the treatment : noting this fact, I attributed it to growth.

Or At present I am treating a patient aged 35 suffering from a static scholiosis, and which presented a 2.5 cm difference of the lower limbs. After 4 months of treatment, whereas scholiosis has improved, the length of the lower limbs only shows a difference of 1 to 1,5 cm

These last two observations show that the behaviour of the spinal muscles influences the attitude of the limbs, unlike what is currently admitted, which explains that wearing "foot-levellers" cannot heal static scoliosis.

E ABOUT FLAT FEET

I mentioned earlier, the reasons explaining them and how they can be remedied through the treatment of the plantar arch only. However, long before the war, DR SHOTT had observed that the calcaneum inclines on its internal side when the foot goes flat and you only need to redress the heel in order that the arch is formed again. Treating the cause and not the effect, he built up a device that supports the sustentaculum-tali. It seems that this fantastic discovery nearly came unnoticed ! For my part, I didn't see any muscle attached to the calcaneum to raise its internal side (I don't include the digitation of the posterior leg muscle on the apophysis, which would be insufficient and which is undoubtedly changeable, anatomists failing to mention all of them), I think that the inclination of the rear tarsus on the internal side can only be owed to the overhang of the tibio-peroneal mortise on the ankle bone. The vicious attitude of the lower limb is provoked by the one of the rachis, It is the latter
that must be treated to correct flat feet.

F CONCLUSION

To summarize the lessons of these facts, the stiffening of the muscles of the canals is to blame for :

Non traumatic or rickety thoracic distortions.

All the vertebral pains called : »rheumatic ».

Stiff necks, lumbagos, etc.

Discal pinches and vertebral subluxations.

Pains called « arthritis-rheumatic » with the exception of infectious rheumatisms.

Unequalities or vicious attitudes of the limbs, and, most likely flat feet.

I even think that the lesion of the sus-spinal muscle, being blamed for the fibrositic peri-arthritis of the shoulder, and to which part of arm suspensor it is assigned and which part is played by this muscle and for which it wouln't be made, is indeed rather the consequence of the vicious attitude of the acromion of the shoulder. This attitude is provoked by the shrinking of the spinal muscles. Like the lower limbs, the arms are affected by the rachidian behaviour.

CHAPTER III

SCIENTIFIC DATA

All these facts may be surprising and they didn't fail to amaze me when they appeared.

It is thus necessary to refer to the most recent scientific data in connection with the standing position, with the movements and their effects on the rachis.

Those data are explained by Vandervael in the book called :
« Analyses des Mouvements du Corps Humain »

A. THE STANDING POSITION AND THE ATTITUDE OF THE RACHIS IN THIS POSITION.

There are, in this attitude, three behaviours :

- the standing position
- the normal position
- the military stand-to-attention position

1° The vertical position is possible and doesn't request any contraction of the muscles of the trunk(hence the weight doesn't tend to bend the body forward), but the centre of gravity falling then between the two heels, the sustentation polygon is reduced to their circumference. Because of the exiguity of this base the balance is unstable and the vertical position is never adopted.

2° The normal position uses then the entire plantar arch as a sustentation polygon, which gives a wider base but it is then necessary to move the centre of gravity forward by letting the belly go forward, and then arching the back backwards (hence the lumbar-dorsal curve) and moving the neck and the head forward ; To enable the sight to be horizontal, the head tilts backwards(hence cervical lordosis).The balance is then very stable and doesn't request any muscular contraction.

Ii is to be noticed that two anterior and posterior vertical planes , tangential to the body, would be in contact with the latter, the first at the level of the navel, the second at the level of the shoulder blades.

So, despite its curvatures, the rachis then shows two posterior concavities : a lumbar-dorsal one facing downwards : the dorso-cervical one facing upwards.

The seemingly bent region is the junction point of those two concavities. It is located at the level of the shoulder blades ; these ones exaggerate its aspect.

This explains why the classical treatment, which thinks cyphosis can be remedied by the « extension exercises» clashes with the « intractable zone ».

These exercises have the effect of compounding the arching of the body backwards, which causes the exaggeration, by compensation, of the attitude of the neck and of the head.
The lumbar-dorsal and cervico-dorsal concavities lengthen and their junction point is confirmed. There is then no « intractable » zone but there is a necessary zone for the standing balance.

The normal position, which diminishes the height of the waist, is all the more stable that it is exaggerated. It is then called the asthenic attitude, which is inappropriate because it is the mere accentuation of a normal position which doesn't request any muscular contraction. (the explanation of that aggravation has then to be found out).

If the normal position doesn't request any strength of the posterior muscles, it puts, however, under tension the anterior vertebral common ligament which, says Vandervael, can alone support the weight of the trunk.

It is then understandable why it becomes injured and likely to tear and even ossify.

3° Lastly the military stand-to-attention position, or initial standing position of gymnastics (static), or else the correct position, uses the entire plantar arch as a sustentation basis but, requesting the biggest height of the waist, all the vertebral curvatures, must be lessened. The centre of gravity can't be moved forward by the forward projection of the belly that it would then be necessary to compensate by pressing the rachis. The whole body stoops then forward, in one go. It is held by the contraction of the major gluteal and of the canal muscles, but the vertebral curvatures being lessend, the latter ones perform excentric work. The head flexors(sus- and sub- hyoid, sterno-cleido mastoid and pre-vertebral bones) are contracted, which means that their action, added to that of the gluteal muscles, exerts on both ends of the rachis a pull which lengthen their curvatures. The transverse muscle smooths the abdomen whereas the lower fascicles of the trapezia, the adductors and external rotators of the arms (small finger on the seam of trousers) smooth the dorsal curvature by throwing out the chest. These muscles exert on the spinal muscles a concentric pull at the level of the scapular belt. This behaviour requests : the total flexibility of the « extensors » considering their contraction(minimal anyway) is excentric, and the « muscular direction» to keep those different muscles contracted.

Not being in an upright position, the body could not be, as imagined, in contact with a wall by means of the calves, the buttocks, the back and the head.

This position, the only correct one, is all things considered an articial attitude, difficult to achieve, and , that only the conscripts of the military service and the static gymnastics fans adopt (or rather try to adopt)

Examining those three standing positions, it can be seen that the force of the spinal muscles doesn't have to intervene in the vertical position, nor in the normal postion but only and for a minor part, in the artificial attitude. (Mainly the major gluteal muscles come then into action). Though their flexibility is necessary to this attitude, considering their contraction is both static and excentric.

In the normal standing position, the rachis is pressed : its two posterior concavities occupying the major part of its surface, it is :
- shrunk, behind its transversal axis
- lengthened ahead of the axis

The « extension possibilities»(« i.e. of backward flexion) are not reduced , but those of the forward flexion are.

This is by all means the consequence of the fact that the dorsal segment is not very flexible. Indeed Vandervael indicates for each vertebral segment, the following angle measures between the extreme flexion and the extreme extension :

135 to 150 degrees for the head and the neck.
70 degrees for the lumbar region
45 degrees only for the back

This little flexibility ahead of the dorsal explains the conclusions of the observation III, especially :

- that the real dorsal cyphosis only exists in case of cuneiform vertebrae and

- that the apparent cyphosis is in reality the junction point of two lordosis and that is as a matter of fact only, in this instance, a scapular cyphosis.

The lordosis will be all the more admitted being the origin of misalignments, if we consider that not only the normal standing attitude provokes it, but also that any movement of high amplitude of the limbs and the trunk, cannot be carried out without a lordotic compensation.

Indeed the elevation of the upper limbs is only possible as high as 150 to 160 degreess. Beyong that angulation a lordosis is necessary. Their outward rotation provokes the dorsal disappearing or inversion (thus the lordosis). The coxo-femoral joints only tolerate abduction at an angle of 45 degrees and the outward rotation at a maximum of 60 degrees (from the extreme internal rotation).

The lordosis, inevitable beyond those angulations, can occur at different levels.
This is why the Italian school of classical dance adopts the lumbar curve, whereas the French school lessens it in the lumbar region to spread it to the dorsal region.

In fact those lordosis, compulsory for dansers and acrobats, are at the origin of the misalignments which are so frequent with them.

Regarding the amplitude of the movements of the trunk, the limited forward flexibility of the dorsal region and, however, the constance and importance of the scapular cyphosis (corresponding to the cervical it dissimulates), are highlighted by the following exercises :

1° Sitting on the floor, with the legs spread out, the arms forward, the patient bends to touch his feet. The back looks then like having a strong cyphosis.

In reality there is only one scapular cyphosis concealing a cervical lordosis along with well marked first dorsal vertebrae and sometimes (when the illip-tibial muscles are flexible enough to allow for a more ample flexion of the pelvis) a lumbar lordosis.The flexion is performed at the level of the coxo-femoral vertebra but it is confusing in proportion as the dorsal convexity is striking. The trunk doesn't carry out a flexion but it carries out a lean of the body. The following exercise proves it :

2° Sitting on the floor, with the legs spread out, the chin near the neck, the sight being horizontal, trying to « drop the nape of the neck » and raise the occiput, the hands to the shoulders, the elbows to the body,with the wrists outwards to avoid the elevation of the scapular belt, the patient tending to grow taller.

The flexion of the body(while holding the position of the head and of the hands) will be barely perceptible because the spinal muscles will be put under tension ; the stiffer they are , the less easy the exercise is. It won't be easy either for many people to adopt the starting position.

This exercise demonstrates not only that the ample « flexion » of the trunk is possible at the cost of a lordosis only – and its complement the scapular cyphosis , But even though a pull is exerted on the entire length of the spinal muscles and on the upper fascicle of the trapezium, neither a lordosis, nor a cyphosis are possible.

This explains why the different misalignments in the antero-posterior direction are cured by the relaxing of its muscles.

It must be noted that , from these two examples,

The first is a « free » exercise the starting position of which doesn't request muscular contraction. It can even be carried out running up and only requests the flexibility of the illio-tibial muscles. It performs a lean and not a flexion.

The second is a static exercise because of the prior contraction of the flexors of the head and of the lower fascicles of the trapezia.

Despite its weak amplitude, it requests a great flexibility of the muscles of the canals and a great strength of those that stretch them, at the same time as a trained muscular sense and a strong concentration of the mind.

Because of the aspect of this type of exercise, which characterizes true static work, ignorant people
describes this gymnastics as« stiff and boring »

This vertebral compensation required for the natural standing balance and for the amplitude of the movements, seems to explain the formation of cervical and lumbar curvatures, in the human being.

Comparing the direction of the fossa of the shoulder blade and of the cotyloid cavity on the human and ape-like skeletons, I noticed in fact that in apes the orientation of those cavities seems to allow very high amplitude movements. On the other hand, the standing attitude, without resting on their hands is exceptional with them. I thus think that these are the reasons why they hold the only posterior vertebral convexity which is also the case with human beings at their birth .

B CONCLUSION

The deductions of the observations match the scientific data very well abd we are led to admit that every healthy human being is lordotic but is unaware of it and that sooner or later they will be suffering from misalignments or pains. But this is not exaggerated.

Indeed, if we admit :

1° That extensibility, liket he muscular strength anyway, must be kept in good condition or else it will disappear;

2° That, when a joint is constantly maintained in the same position, the consequence is the stiffness of the ligaments the insertions of which insertions are closer and a laxity of the ones the insertions of which are further apart.

We should admit :

1° That the muscles and the ligaments posterior to the transverse axis get stiffer and

- those anterior to the same axis (anterior vertebral common ligament, pre-vertebral, sus- and sub-hyoid), abdominal (mainly the rectus abdominis muscle) are distended;

2° that this ligamentary and muscular behaviour tends to develop non-stop. With old age, the stiffness and the arched shape appear clearly. Rheumatism is also the prerogative of ageing. We also notice the waning of the anterior part of the neck and of the belly (owed to the distension of their muscles). To change things, attitudes or natural movements should act on the rachis, unlike the standing position, but there aren't any and we have seen that the attitudes capable of stretching the rachis behind its posterior axis (military stand-to-attention position, posture, capital suspension in sitting position), are artificial and difficult to achieve.

The attitude called « asthenic » being an exaggeration of the normal attitude, it marks the first degree of that evolution which will end up with dysmorphisms, vertebral pinches and pains observed earlier

So a cyphosis doesn't bring about misalignments

The weakness of the extensors is neither to be blamed and their stiffness must be fought.

On the other side, the normalisation of morphology, observed after the treatment, whatever the case and age of the patient, enables to perceive the reason why the human being seems so little favoured as far as the esthetic is concerned. The « Frank Type » i.e. harmonious is, indeed, an exception. The level and the size of the lordosis determine morphologic types which are lessened by the vertebral stretching. The misalignments following pregnancy are also owed to the exaggeration of the curve during that period.

C ABOUT THE METHOD : ITS AIMS - ITS MEANS

The notions on the origin of misalignments, those in relation to the cause of pains examined previously, being confirmed, the resulting treatment is theoretically very simple. It aims, whatever the case, to lengthen the rachis to smooth all the curvatures. It is designed, simultaneously and in reverse order, for the planes anterior and posterior to the transverse axis of the spinal column.

In the anterior plane, it aims to :

Shrink the trunk vertically and stretch it transversally at the level of the scapular belt

In the posterior plane, it aims to :

Lengthen the trunk vertically and shrink it transversally at the level of the scapular belt

Accordingly, the muscles to be relaxed are the spinal, post-cervical ones, the upper fascicles of the trapezia, illio-tibial, major pectoralis muscles and the internal rotators of the arms, the adductors.

Their stretching, passive in the beginning, will be the work of the postures which will form the first part of the treatment.
It will be active in the second part of the treatment which will comprise the training and the shrinking of the muscles capable of stretching those mentioned earlier, especially : the pre-cervical, sus- and sub-hyoid, sterno-cleido-mastoid, abdominal muscles, quadriceps, flexors of the foot,lower fascicles of trapezia, external rotators of the arms, major gluteal muscles.

D CONCLUSION

The therapy taught and applied up to now, fails because it was designed after the reasonings grounded on the illusory explanation of the standing position.

Once again, the anti-cartesian systems are dumbfounded by the careful observation and without preconceived ideas, of the facts. We see that, related to the most recent analyses of the corporal static, the lessons, resulting from the facts observed, correspond to them perfectly. The reality is at the opposite of what we are wrongly persuaded of. The results obtained by the classical means (which condamn la method) and those I have been getting since experience pushed me to act otherwise, are the speaking evidence that we have been in the wrong up to now.

Whereas lethargy is the main abnormal behaviour which has been treated, the muscular stiffness is as a matter of fact harmful and should be treated in first instance.

Though it was thought that the spinal muscles could be stretched partially (and being involved in only a few cases) the conclusion is that the result is impossible, that the entire surface of the muscles should be treated and that is the only aim to be sought after by all means;

Then, whereas everything was attributed to the partial or total lethargy of the spinal muscles, and consequently a wealth of cases and therapic systems was envisaged, everything must come down to the stiffness of the muscles and, accordingly, one only case (the lordosis) must be considered so that the total stretching of the rachis is the only curative means of the misalignments.

Whereas it was aimed to shrink the trunk behind the vertebral transverse axis and lengthen, consequently, the anterior muscles of the neck and of the abdomen (the excentric work of which was sought after), it is the lengthening of the trunk behind the vertebral transverse axis and the shrinking of the muscles that must be achieved.

Whereas the abnormal behaviour of the spinal muscles (which were thought to be lethargic) was considered to be likely to generate only vertebral misalignments and which was thought to be revealed by it, it is now confirmed that, not only the abnormal behaviour of those muscles (which is stiffness), engenders beyond misalignments, loads of pains I mentioned ealier but though it is not always visible and it must be currently appealed to postures to detect it.

Whereas the attitude of the lower limbs and of the pelvis is considered to influence the one of the rachis, the vertebral behaviour must be blamed for the effect on the lower limbs and the pelvis.

Unlike what is admitted and practised, the therapy I recommend is as simple in its theory as it is delicate in its application.

It will thus be necessary, not only to extend the domain of the physiotherapy and include in it the cases called « Asthenic attitudes », « paramorphisms », the distortions following a pregnancy, the exaggerations of morphologic types and the pains which were mentioned earlier, but also reduce its application to the only physiotherapists. The latter will have to devote themselves to the sole practice of that speciality. In addition, it will be indispensable to revise the teaching that is given to them.

However, what gives rise to these lines is not the attraction of the pure criticism of what is being done : on the one hand, driven by the love for my profession, I cannot admit that,because it is misunderstood,gymnastics is regarded either as a risky means to treat misalignments. On the other hand, I cannot think,without being frightened of the unfortunate people who are the victims of that ignorance. To those who , suffering in corsets, sleeping on boards or in shells, enduring often brutal manipulations, devoting time and money to gymnastics, end up with a graft which will turn their rachis into a rigid rod !! To those at last who can't live and work normally, those very people who wanted to be cured, who used the most perseverance, and who, because of it precisely, have become handicapped people…

With the hope of being useful to them, I wish the technicians to experiment, with the control of the radiotherapy, the method which a ten years' work has taught me.

For the latter, I thought that on the eve of this thirtieth anniversary, it would be judicious to find in it the text of my first publication which has been out of stock for long. Published in the wake of my observation "princeps", after two years checking on the rules that have been found out, and although the method has enriched considerably, this message stays in full the base of the method.

And, as we come back to our fundamental principles, my collaborator and friend propose you to examine the phenomena used in industry to form the plastic substances of which we see that the muscle behaves like inert matter and that we treat it likewise to reform it.

Lastly I give my thanks to the followers who, early this year, expressed their best wishes to me and to all of them, I give my most friendly wishes of health and happiness.