MIDDLE AND DISTANCE RUNNING 29 
facts, 7. e., the manner in which they have been affected by their run- 
ning; second as to their opinions, 7. ¢., whether or not they consider 
distance racing and cross-country running safe and valuable forms 
of exercise. The facts to which they testify must be considered as 
final; the opinions they express, even if not accepted as conclusive, 
must be of greater value than opinions based merely upon theory, 
for they are the incarnation of living experience, formed through 
days, weeks and months of hard grueling work, through knowledge 
of the manner in which their team mates bore the drudgery of train- 
ing and the strain of contest, and shaped finally by their own physical 
condition during the years which have elapsed since they ran. 
Injuries to the Heart.—In view of the general belief that run- 
ning is apt to injure the heart, particular attention was given to this 
phase of the question. Contrary to expectation, permanent injury 
to the heart was found to be very rare, only three men testifying to 
this effect and in these three cases the injury manifests itself only 
in unusual exertion. Twelve others developed functional heart af- 
fections, irregularity, palpitation, ete. Further correspondence with 
these men shows that all of these functional irregularities have been 
entirely cured. Ten of these fifteen men had what is known as “ ath- 
lete’s heart,” three of the cases persisting to this day, as stated above. 
Generally speaking, the term “athlete’s heart” is very vaguely 
comprehended. In medicine, it is defined as compensatory car- 
diac hypertrophy—that is to say, it defines a heart which although 
it has become enlarged, still performs its functions perfectly. Such 
a heart is normal in an athlete or in any man who performs vigor- 
ous physical exercise, the fibers growing firmer and larger as the 
demands upon the organ increase, just as a man’s muscles grow 
firmer and larger under a month’s outing in the woods. In almost 
every instance a heart of this type will shrink to approximately its 
former size without injury to its tissues, after the exercise has been 
discontinued. When, however, 2 man pushes his exercise too far, 
his heart may develop valvular insufficiency, palpitation or other 
functional irregularity, and I am inclined to believe that this is what 
the average physician means when he tells a man that he has “ ath- 
lete’s heart.” This was so in most of the cases mentioned above, 
nevertheless, all but three of the men have since been cured. “ Ath- 
lete’s heart” is usually a temporary condition and permanent injury 
from overwork is rarely found. In an experience with school boys in 
all branches of athletics extending over a period of fifteen years, I have 
met with but one case of true athlete’s heart, and this boy’s physician 
told him that if he would abstain from violent exercise for six months 
he would be entirely cured. This heart affection was brought about by 
two years of hard training for the mile, beginning at an early age. 
This case, together with the free expression of opinion from athletes to 
