THE PHYSIOLOGY OF MUSCULAR WORK 253 



great medical importance. The majority of the best athletes 

 examined have passed albumin in their urine after contests in sport, 

 such as rowing, running, and football ( B0 ). Is this albuminuria to 

 be considered pathological or physiological ? It is probably the 

 expression not of disease but of disturbance in the supply of blood 

 and oxygen to the kidneys during strenuous work. This is pro- 

 bably the reason why most cases of albuminuria are found among 

 the best cfews and teams ; the men with the best physique and 

 the best training are capable of the greatest exertion. During 

 rest the albuminuria disappears. 



The subject demands attention, for there is no doubt that men 

 have been rejected for life insurance on account of this albuminuria, 

 and many have been treated as the subjects of serious disease of the 

 kidneys. It is difficult to imagine how much worry and misery 

 may have been caused by the failure to recognise that albuminuria 

 is not necessarily a sign of renal disease. 



MUSCULAR WORK AS A CAUSE OF FATIGUE 



Fatigue is a condition which it is very difficult to define or 

 analyse. Excessive activity of any part of the body brings about 

 a state of increasing inefficiency. The chief characteristic of 

 fatigue is inefficiency, and a classification of fatigue might be based 

 upon its apparent seat of origin. Fatigue due to muscular activity 

 alone needs consideration in this article, but it must not be thought 

 that the condition is one in which the muscles alone are involved ; 

 it is impossible to exclude other parts of the body, for muscular 

 activity affects all parts ; the body works as a whole. 



Muscular work produces fatigue, and its onset depends upon 

 the nature of the work, its duration, and the external conditions 

 under which it is performed. An analysis of the sensations of 

 this fatigue shows that there is a local fatigue, a muscular soreness 

 and discomfort due to the excessive use of one group of muscles, 

 and a general sense of fatigue which follows a more uniform activity 

 of the muscular system. Local fatigue may quickly manifest itself 

 when a special movement, to which the body is not accustomed, 

 is performed. The muscles quickly tire and respond with weaker 

 and less orderly contractions. The causes of this condition are 

 not well known, but it would appear that lack of sufficient nutri- 

 tion, including oxygen, is one of the most important ; waste pro- 



