Masoh 26, 1909] 



SCIENCE 



489 



forced expiration witli closed glottis and 

 it was found that this act alone (without 

 the lifting) caused a similar rise. I can 

 confirm this statement from experiments 

 made in my own laboratory. 



These facts are enough to show the ex- 

 tent to which certain forms of muscular 

 activity may raise arterial pressure and we 

 can not but regard this condition, even in 

 the young, as a source of danger. The 

 risk of cardiac dilatation, valvular insuffi- 

 ciency and injury to the arterial wall 

 have been frequently pointed out, and it 

 does not seem that the need for the utmost 

 caution is put aside by the argument that 

 investigation fails to show bad effects on 

 health among those who have engaged in 

 athletic contests in the past. Meylan's" 

 very careful and satisfactory study of the 

 Harvard oarsmen from 1852 to 1892, in- 

 clusive, undoubtedly shows marked free- 

 dom of these men from cardiac or other 

 vascular troubles in later life, and force 

 the conclusion that this most vigorous of 

 athletic trainings is consistent with the 

 subsequent good health of those who 

 "make the crews." But these are the 

 picked men, physically, of the university 

 and the facts only show that with proper 

 training and under proper medical super- 

 vision these picked men may engage in 

 such work without harmful after-effects. 

 But it is one thing to supply adequate 

 medical supervision to a team or crew, 

 and quite a different thing to supply it to 

 a large student body engaging in athletic 

 training; for no medical supervision can 

 be regarded as adequate unless it detects 

 the signs of mischief before it has gone 

 beyond the possibility of repair. In the 

 absence of such supervision it is simply 

 common every-day prudence to keep phys- 

 ical effort well within the bounds of safety. 



' Meylan, " Harvard University Oarsmen," Har- 

 vard Oraduates' Magazine and American Physical 

 Education Review, March and June, 1904. 



The best gymnasium instructors watch 

 carefully for signs of strain, such as skin 

 pallor, labored breathing and the like, dur- 

 ing a run and diminish at once the inten- 

 sity of the work. And in doing so they 

 are only putting into practise the hygienic 

 principle which we have already drawn 

 from the consideration of the probable 

 extent of adaptation of the race as a 

 whole to muscular activity. The average 

 man or woman, the average boy or girl, is 

 not adapted for extreme effort, and it is 

 not proved by experiment or experience 

 that, in such cases, training can supply 

 what heredity has failed to furnish. 



Passing to the second condition of strain 

 imposed upon the organism by athletic 

 activities, that of vigorous but not su- 

 preme effort continued over longer periods 

 of time, I shall cite only the observations^" 

 made for three years upon contestants in 

 the Marathon Race held annually under 

 the auspices of the Boston Athletic Asso- 

 ciation. These show that at the close of 

 the twenty-four mile race (two and one 

 half to three hours) there was always an 

 enlargement of the heart with a systolic 

 murmur (which, however, Larrabee hesi- 

 tates to attribute to mitral incompetence), 

 that all the signs pointed toward lowered 

 mean blood-pressure ; that the blood counts 

 showed "a leucocytosis corresponding in 

 intensity and type with that observed in 

 various inflammatory diseases "; and that 

 the urine invariably contained traces of 

 albumin and more or less blood. 



This presents to us the picture of the 

 organism struggling with the conditions 

 of marked general fatigue, especially in 

 the working of the heart and of the vaso- 

 motor mechanism. The circulation is be- 

 ing maintained under extremely unfavor- 

 able conditions and presents every sign of 

 venous congestion with its resulting inter^ 



^° Blake, Larrabee and others, Boston Medical 

 and Surgical Journal, CLXVIII., 195, 1903. 



