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Exercise





In recent years a great change has come over the popular mind
regarding exercise, especially in the open air. It is well to
emphasize at the very beginning the subject of too much exercise,
because there is no doubt in the minds of many who study the question,
that many Americans, and indeed people of the northern nations
generally, take a certain amount of voluntary exercise that is
not good for them, though they take it at the cost of considerable
effort and sacrifice of time and are firmly persuaded that it is of
great benefit.


Sufficient Exercise.--There is a much larger number of persons who do
not take sufficient exercise. The amount to be taken is eminently an
individual matter. Neurotic patients exaggerate everything in either
direction, so that perhaps the state of affairs that exists is not so
surprising as it might otherwise seem. Instead of the uncertainty that
prompts now to too much exercise, and again to too little, for
health's sake there must, as far as possible, be a definite settlement
of the needs.


National Customs.--There is a curious difference in the attitude of
mind of the various nations towards exercise. Most of the southern
nations of Europe do not as a rule take any violent exercise. As is
well known, however, they are not for this reason any less healthy
than their northern contemporaries, though perhaps they are less
strong and muscular. But muscularity and health are not convertible
terms, though many people seem to think they are. An excess of any
tissue is not good. Our economy should be taxed to maintain only what
is useful to it. Nature evidently intended, in cold climates at least,
that men should maintain a certain blanket of fat to help them retain
their natural heat, but any excess of fat lessens their resistive
vitality by lowering oxidation processes. Fat in cold climates can be
used to advantage as a retainer of heat. In the warmer climate it
would be a decided disadvantage. Muscular tissue is a manufacturer of
heat and this is a decided advantage in the colder climates, but in
the temperate zone, where the summers are very warm, muscle in
over-abundance, unless its energy is consumed by actual physical
exercise, may be quite as much of a burden as fat. Muscular people do
not stand heat well. They demand exercise to keep muscle energy from
being converted into heat, and they require frequent cold baths, and
other forms of heat dissipation, in order to be reasonably
comfortable.


Exercise in Early Years.--The question of the amount of exercise that
is to be taken must be decided at an early age for individuals. Most
of the young people of the Celtic and Anglo-Saxon races are tempted by
traditions and by social usage to develop considerable muscle during
their growing years. In this respect, the difference between the
German and the English schoolboy is very striking. The English
schoolboy is likely to be as "hard as nails," as the expression is, as
a consequence of violent exercise in his various sports, taken often
to the uttermost limit of fatigue. The German schoolboy has his walk
to and from school, and some other simple methodical exercises, with
some mild amusements that make little demand on muscle, but of games
in the open he has very few, and of the violent sports he has none at
all. A comparison of the health of the two nations will not show that
the English boy, who receives a public school and a university
education, with all their temptations to exercise, enjoys any better
health, and, above all, reaches an average longer life than the German
youth, who has gone through a similar educational career in his own
country, but without the athletic training that the English schoolboy
has had.

As a consequence of the absence of athletics and its diverting
interest, the German is apt to have learned more than his English
colleague, but a comparison of mortality and morbidity tables
would show that his resistive vitality, his power to overcome disease
and recover from accident is not lower than that of his colleague from
across the North Sea. The German is less strong muscularly, and in a
contest of physical effort would as a rule come out second best, but
then we have gotten beyond the period when it is important for a man
to be able to defend himself by physical force, except in emergencies
that may never come. Surely the English time and effort devoted to
athletics is not justified by this.


Preparation for a Sedentary Life.--Certainly if a young man is going
to live a sedentary life in his after years, it does not seem
advisable for him deliberately to devote much time to muscular
exercise during his growing years. This only provides him with a set
of muscles for which he has no use. Ordinarily it is assumed that
muscles are organs for the single purpose of evolving energy. This is
not true, since they are important organs for the disposition of
certain food materials and for the manufacture of heat for the body.
Nature in her economy probably never makes an organ for one function
alone, but usually arranges so that each set of organs accomplishes
two or three functions, thus saving space and utilizing nutrition to
the full. The man with a well-developed muscular system, which he is
not using, will have to feed it, and besides will have constantly to
exert a controlling power over the heat that it manufactures whenever
it is not dissipated by actual exercise. For these reasons he will be
constantly nagged by it into taking more exercise than his occupation
in life demands, and if he does not do this, his developed musculature
is likely to deteriorate so as to be a serious impediment, or to
degenerate by fatty metamorphosis into a lower order of tissue that is
a clog and not a help to life.

The Germans are more sensible. As students, they live quite sedentary
lives, develop their muscles just enough to keep them in reasonably
good health, and then, when it comes to living an indoor life, as will
be almost inevitable in their chosen professions or occupations, they
do not meet with the difficulties that confront the Anglo-Saxon with
his burdensome, over-developed muscular system. German professors, as
a class, do not find themselves under the necessity of taking
systematic daily exercise. They are quite content and quite healthy
with an hour or two of sitting in the open air, and a quiet walk from
the home to the university or the school. With the ideas that some
people have with regard to the value of exercise for health, it might
be expected that the German professors would be less healthy than
their Anglo-Saxon colleagues. This is notoriously untrue, for the
Germans live longer lives on the average, and most of them accomplish
much more, and above all are much more content in the accomplishment,
than their physically strenuous Anglo-Saxon colleagues. They are not
oppressed by the demands of a muscular system that insists on having
its functions exercised, since it has been called into being in the
formative period. These German professors live to a magnificent old
age, requiring very little sleep and often doing a really enormous
amount of work. The man with a developed muscular system generally
requires prolonged sleep, particularly after exercise, but even
without it very seldom is it possible for him to do with less than
seven hours, while the Germans often are content and healthy with five
hours, or less.



Our muscular system is our principal heat-making apparatus. It is easy
to understand. If we have larger heat-making organs than are necessary
for the maintenance of the temperature of the body, and if we have no
mode of dissipating our heat by muscular energy, as through exercise,
then there will be a constant tendency for our temperature to rise,
which must be overcome, at considerable expense of energy, by the
heat-regulating mechanism of the body. This heat-regulating mechanism
is extremely delicate, yet does not seem to be easily disturbed. With
the external temperature at 120 deg. F. or--10 deg., human temperature is
constant. With a heating apparatus entirely too large for its purpose,
it is no wonder that irritability of the nervous system ensues because
of the constant over-exercise of a function called for from it. It is
this state of affairs which seems to me to account for the marked
tendency to nervous unrest, and to the presence of many heart and
digestive symptoms that often characterize athletes who develop a
magnificent muscular system when they are young, and later have no use
for it. They must learn the lesson and keep up the practice of using
their muscles sufficiently to dissipate surplus heat, so as to prevent
this energy from being used up in various ways within the body, with a
resulting disturbance of many delicate nervous mechanisms.


Useless Muscles.--Whatever a human being has to carry round as useless
can only be expressed by the telling Roman word for the baggage of an
army, impedimenta. Prof. James, in his "Principles of Psychology,"
sums up the law very well:

The great thing in all education is to make our nervous system our
ally instead of our enemy. It is to fund and capitalize our
acquisitions and live at ease upon the interest of the fund. For
this we must make automatic and habitual as early as possible as
many useful actions as can be and guard against the growing into
ways that may be disadvantageous to us as we should guard against
the plague.

An over-developed muscular system, with its tendency to manufacture
heat and its craving to be used, and the consciousness it is so apt to
produce of ability to stand various dangerous efforts, is a
disadvantage rather than an advantage.


Useless Fat.--This reminds us very much of the attitude with regard to
children in the acquisition of fat. Chubby babies with rolls of fat
all over them and deep creases near their joints are considered to be
"perfectly lovely." Mothers are proud to exhibit them. They are
supposed to be typical examples of abounding good health. Neighborly
mothers come in to coo over them and, in general, the main aim of
existence for children in their early years would seem to be to make
them as fat as possible. Such children, as is brought out in the
discussion of the subject in the chapter on obesity, are not healthy
in the true sense of the word, are well known to be of lower resistive
vitality than thinner infants, and easily succumb to diseases.



Resistive Vitality.--One reason for the early deaths of many athletes
is the fact that, confident of their strength, they allow themselves
to become so overwhelmed by an infection, before they confess that
they are sick and take to bed, that often the cure of their affection
is hopeless. Ordinarily neither pneumonia nor typhoid are likely to be
fatal diseases for men between twenty and fifty. If a man's heart and
kidneys are in good condition during this period, an attack of
either of these diseases, while a serious incident, is likely to be
only a passing loss of time. Rather frequently, however, strong and
healthy men without any organic defect that may be considered
responsible for the fatal termination, succumb to these diseases. The
reason for the fatality is that they are not willing to admit that
they are ill enough to be in bed, they have a large reserve force of
strength on which they call and which enables them, for a good while,
to resist the weakening influence of disease. Doctors know and dread
these cases. A young man in the flower of youth, with magnificent
muscular development, comes into the office breathing very rapidly and
with a laboring pulse. Almost exhausted, he sinks into a chair,
confesses that he is nearly "all in," and wonders what is the matter.
At times the physician will find practically a whole lung solidified
by pneumonia, and at times both lungs are seriously affected. The
wonder is how the young man succeeded in holding out so long.
Sometimes the doctor is summoned to see him because he has fainted in
his home, or in his office, and his friends are alarmed. These cases
are almost invariably fatal. Any one who continues to be up and around
until the third or fourth day of pneumonia will have so exhausted his
vitality, no matter how great that may be, that he will have no
reserve force for the life-struggle that must come before the crisis
is reached.

Nearly the same thing is true for typhoid fever in the same class of
persons. A young athlete, who considers it babyish to confess to
illness, complains of feeling out of sorts but nothing more, until
some morning he is literally unable to leave his bed, or has a
fainting fit after going up-stairs. He is found by the physician with
a temperature of 104 deg., or near it, and with evident signs of being in
the middle of the second week of typhoid fever. The termination of
such a case is generally fatal.

The ordinary man knows his limitations better; he recognizes the fact
that he may be ill, and gives in quietly and rests, so that nature may
employ all her energies in conquering the infection. Most of the
long-lived people of history have been rather delicate and have
learned young the precious lesson of caring for themselves. This care
has not been exaggerated, but it has consisted in avoiding danger, in
resting when tired, in not overdoing things, and above all in yielding
to the symptoms of disease before these become serious.


Regulation of Exercise.--Each man must be a law unto himself as to the
amount of exercise that is necessary for him. He must take enough to
use up the energy supplied by the food he eats, just as, on the other
hand, he must eat enough food to make up for whatever waste there is
in his body. There are many men who eat over-heartily and then have to
take exercise to use up this material or else suffer for it. This is
one of the compensations that the hearty eater must pay: he overfeeds
and becomes obese, or, if he succeeds in keeping down his weight to
the normal, it is only by the expenditure of time in securing such
muscular action as will use up surplus energy. Many men find it
difficult to control their appetites, and prefer to take exercise
rather than to deny the appetite which they created during their days
of indulgence in athletics. It is for such men to decide just what
seems preferable. If the fuel is supplied to the heat engine, which
all human beings are, it must be used for the production of energy or
else it will exert itself in accumulating certain waste in the
tissues, just as over-abundant fuel serves merely to clog up the
fire-box of an engine without doing any work.


Air and Exercise.--It is easy to deceive one's self in the matter of
exercise. With regard to air such a mistake is almost impossible. As a
rule, it is air rather than exercise that people need when they have
the restlessness and nervousness which comes from over-abundant
nutrition. Fresh, pure air enables the individual to burn up nutritive
material to the best advantage by the encouragement of oxidation. It
is a surprise to those who are not accustomed to it, to see how
tuberculosis patients who come to sanatoria with very little appetite,
soon acquire an appetite and are able to consume large quantities of
food, to sleep well and become restful--all as the result of living
constantly in the open air during the day, and also having an
abundance of fresh air at night. This is particularly true if the air
in which they live is rather cold, and, above all, if it has a large
difference of temperature every day, so that there is an upward and
downward swing of the thermometer of from thirty to forty degrees.
This varying temperature seems to use up nutritive material, and keeps
all the natural processes going.


Gymnastics.--The very opposite to this plan of open air life is that
followed by those who take gymnastic exercises for health's sake, with
the idea that the use of certain muscles is necessary to keep the
bodily economy in equilibrium. Such gymnastics are usually undertaken
indoors, sometimes in stuffy quarters, and the movements are commonly
repeated with such continued routine that absolutely all interest is
lost. That there are many who advocate this form of exercise, it has
nearly always seemed to commonsense physicians an entirely wrong
solution of the important question of the encouragement of oxidation.
It is like running an engine, not for the purpose of having it do
something, but simply in order to have it oil itself, and consume the
fuel that has been put into its boiler and that must be used up
because more will be put in to-morrow. It would be much better, either
to limit the amount of fuel or to give the muscular exercise some
useful purpose, above all connect it with some interest that furnishes
diversion of mind at the same time that the muscles are used. This
last is the most important consideration, for, after a time,
gymnastics pall in spite of artificial incentive.

Dr. Saleeby, in "Health, Strength and Happiness," has expressed very
forcibly what has come to be the feeling of many physicians with
regard to gymnastics, especially indoor gymnastics:

The natural spontaneous exercise having been forbidden, and the bad
consequences of no exercise having become conspicuous, there has
been adopted a system of factitious exercise--gymnastics. That this
is better than nothing, we admit; but that it is an adequate
substitute for play we deny. . . . The common assumption that, so
long as the amount of bodily action is the same, it matters not
whether it be pleasurable or otherwise, is a grave mistake. . . .
The truth is that happiness is the most powerful of tonics. . .
Hence the intrinsic superiority of play to gymnastics. The extreme
interest felt by children in their games and the riotous glee with
which they carry on their rougher frolics, are of as much importance
as the accompanying exertion. And as not supplying these mental
stimuli, gymnastics must be radically defective.

Granting, then, as we do, that formal exercises of the limbs are
better than nothing--granting further that they may be used with
advantage as supplementary aids, we yet contend that they can never
serve in place of the exercises prompted by nature. For girls, as
well as boys, the sportive activities to which the instincts
impel, are essential to bodily welfare. Whoever forbids them,
forbids the divinely appointed means to physical development.


Play and Exercise.--There has been a distinct tendency in modern times
to think that gymnastic exercise can be a substitute for play for
growing young folks. When certain of the instruments and methods of
the modern systems of gymnastics which have been introduced into
schools, and are supposed to be so wonderfully beneficial, are put to
the test of the psychology of exercise, the conclusions are likely to
be very different from the theories under which they were introduced.
Dr. Saleeby has expressed these differences rather strikingly:

Anyone who will consider for a moment the natural constitution of
man and the principles of natural education, must agree that the
deplorable thing called a dumb-bell offers an exquisite parody of
what exercise should really be. The cat, as she exercises her
kittens along the lines of their natural proclivities and needs,
never telling them that this is exercise for the sake of exercise,
and certainly prepared, if she could, to turn up her nose at any
artificial implement we might offer her--should be our model in this
respect. It may be imagined that some unfortunate girl, brought up
on early Victorian lines, having never been permitted to wear
comfortable garments, or to stretch her arms, would welcome and
enjoy the dumb-bells when first introduced to them. But any one who
has had a natural childhood and who has been taught to play, and who
has taken his or her exercise naturally, or incidentally in the
course of pursuing some mental interest--any such person may be
excused for saying that a pair of dumb-bells should be deposited in
our museums as indications of what was understood by exercise even
as late as the earlier years of the twentieth century. All exercise
for the sake of exercise is a mistake--or, at any rate, a second
best. You may do your mind--and body, too--more harm by sheer
boredom than you may gain good from the exercise you go through. The
dumb-bell symbolizes the fact that the most elementary and obvious
truths of psychology are still unrecognized, though the play and
games of every natural child--if you object to be instructed by
kittens--should be perfectly sufficient to teach us what indeed
nature taught us ages ago, if only we would listen to her.


Indoor Sport.--Indoor sport is another thing. In wintry weather it is
impossible to play outside conveniently, and indoor games have their
place. Unfortunately they are usually associated with dust, and when
played before crowds of spectators, the participants suffer also from
the disadvantage of rebreathed air containing, too, the emanations of
those who are looking on. It must not be forgotten that these two
factors are the most prominent predisposing causes of tuberculosis.
Those who have any tendency to tuberculosis, by which is meant
specifically all those who are associating with tuberculosis patients,
whether those patients are related to them or not, or who are more
than 20 per cent. under the weight that they should have for their
height, should not be allowed to take part in indoor sports where
these drawbacks are sure to be encountered.

Sport, because of the diversion of mind involved, is an ideal form of
exercise. An exercise that becomes a mere routine and that can be
eventually gone through with so mechanically as to leave abundant room
for thoughts of business or study or worries of other kinds, loses
sight of one of the principal purposes of exercise as nature demands
it.


Horseback Biding.--It is because of the complete diversion of mind
that is necessarily involved in it, that horseback riding makes such a
magnificent exercise for the busy man. The old expression "the outside
of a horse is the best thing for the inside of a man" is founded
even more on the mental influence of horseback riding than its
physical quality. The same amount of exercise in the open air, taken
otherwise, often does not accomplish so much good, because a man's
thoughts may continue to run on his business or be occupied with his
worries, or he may not be able to divert his thoughts from himself and
his digestion or his ills. A horseback rider must pay attention to the
other animal, rather than himself, and that represents the complete
diversion of mind so necessary for the health of most people. Just as
soon as man rides an old favorite animal on whose back he can throw
down the reins, allowing it to saunter on as it will, while he
occupies himself with other things, then horseback riding loses its
efficacy and falls back into the class of bicycle riding or carriage
riding or walking in the open air unless there is diversion of mind in
the scenes, or the necessity for care at street crossings, to banish
preoccupation of mind. Unless business troubles and worries are
necessarily excluded by its conditions, or are deliberately eliminated
from the mind during the course of any exercise, it may even become a
renewed source of worrisome thoughts, rather than a renewal of energy,
mental and physical.

It is doubtful whether horseback riding should ever be recommended for
those who have not been accustomed to it from their youth. To ask a
man past forty to learn to ride horseback for the sake of exercise is
nearly always a mistake. It becomes a trial rather than a recreation,
and may thus do harm rather than good. On the other hand, horseback
riding is one of the things that may be, and indeed often is, much
abused. The old English fox-hunting squire would never have lived out
his life even as long as he did, consuming the amount of proteid
material that was his custom, and drinking his three or more quarts of
port at dinner every day, but that the excessive drain upon his system
by long days of hard riding in the hunting field made calls upon his
nutrition which kept even this amount of food and stimulant from doing
immediate harm. Just as soon, however, as long spells of severe
exercise become excuses for the consumption of big dinners, and
exercise is used as a factor to enable one to overeat with more
comfort than would otherwise be the case, a vicious circle is formed,
and one serious abuse is counterbalanced by another. What many
well-to-do people of leisure need is not so much more exercise as less
eating.


Walking.--Perhaps the best and most readily available form of exercise
for most people is walking. It has one disadvantage. As soon as the
walk becomes too much of a routine, and the ground gone over has lost
its interest, or is even of such a nature as to permit or, indeed,
tempt introspection and occupation with other things, rather than with
the surroundings, then walking loses most of its efficacy as a form of
exercise. Walking in the country, for instance, becomes monotonous,
though at first it is a great source of pleasure. Walking in a large
city, however, has little of this objection and as large city life has
grown more and more strenuous in recent years, the good effect of
walking to and from the office or walking in the busy parts of the
city has been increased. Between the trolley and the automobile, and
the hustling commercial traffic of the streets, it is impossible for a
man to walk through the busier portions of any large American city
without keeping his wits thoroughly intent on what he is doing, nor
without requiring all of his attention for his transportation.
An abstracted man will in the course of a half hour have so many
narrow escapes from being run down in a busy quarter that he will
either eschew walking in that particular neighborhood, or give up his
habits of mental abstraction, or else he will come to himself some day
in a hospital.

Besides, the passing show in city life is itself of surpassing
interest. It is not things but men that interest us most. There are so
many phases of human life to be seen on busy city streets, so many
things happen in the course of even a short walk to bring out
prominently traits of human nature that, if a man is at all
sympathetic, he finds much to occupy his attention, to distract him
from his own worries and take him away from his business cares. The
long walk to and from the office may thus become an efficacious source
of thoughts that are different and of profound pleasure. All depends
on the man and his mood. Men who try it whole-heartedly soon find a
renewed interest in life. An hour of daily walking in the open air
with the distractions of city life all around, provided the walking is
done briskly and faithfully, is of infinitely more hygienic value than
an hour of gymnasium work. There is only one thing that hampers this
form of exercise--there are so many excuses to tempt one not to keep
it up. If one gets to a gymnasium there is an instructor or director
who keeps tabs on one's hours and so helps a weak human will, and
excuses are easier made to one's self than to others.


Massage as Exercise.--This curious tendency of men to take their
exercise far more regularly, provided some other is concerned in their
taking it so that it cannot be neglected without explanation, is
illustrated in many of the experiences of the doctor in modern life. A
number of forms of massage have come into vogue as wonderful
cure-alls. It is comparatively easy for some men, and above all for
many women, to take their exercise by means of massage rather than in
some more vigorous way that requires their own initiative. A man who
is working hard, and who feels the need of exercise, will not take the
easy natural way of getting up half an hour earlier, having his
breakfast half an hour sooner and then walking down to his office four
or five miles, but he hears of someone who gives vigorous massage and
he engages him to come every morning and exercise him for half an hour
or an hour. In order to do so, he has to get up an hour earlier, but
the fact that he has the engagement with someone else, rather than
with himself, makes it more difficult for him to make excuses, and so
morning after morning, in spite of the fact that he may have been up
late the night before, perhaps to a big dinner, he gets up to be given
his exercise. If he is a heavy eater he will, of course, at the end of
a week or ten days feel ever so much better for he has been using up
material that was clogging his circulation and irritating his nervous
system.

At the end of a month he will probably feel so much better that he
will conclude that he has found the root of all evil in life, or of
all disease, in a failure of circulation that can be removed by means
of massage, manipulation and passive movements. When he gets well
enough to give it up, he drops straight back into his old troubles,
because what he needs is a radical change of life that will adapt his
eating to the amount of exercise that he takes, and his exercise to
the amount that he eats. If this fails to come, he has had only a
temporary benefit that has probably tempted him rather to increase
the amount that he eats normally than otherwise and will
probably do him harm in the end. This massage brings about a distinct
reduction in the weight of women, and as most of them are very
desirous of this, the remedy becomes even more precious to them than
to men. Here, too, however, it is only a temporary expedient. They are
tempted to eat more than before, or at least not to reduce their diet,
and the good that is accomplished is only for the moment, while no
habits, either of restraint of eating, or of more exercise in the open
air which so many of them need, have been formed.


Passive Movements.--The success of osteopathy has been largely founded
on this curious peculiarity of human nature. People are not satisfied
to regulate their eating and exercise in a sensible way. They prefer
to submit to various methods of exercise, manipulations and passive
movements which make up for the muscular exertion that should help the
circulation within the body, but do not accomplish the purpose nearly
so well as the voluntary exercise of muscles. It requires little
exercise of will to submit to this treatment, while for many people it
requires considerable exertion of will power to exercise their muscles
for themselves. The old particularly, who are likely to suffer from
achy conditions around joints, always worse on rainy days, which would
be expelled by enough exercise to stimulate the circulation in these
structures, find the new remedial measures of vicarious exercise of
great service to them and consequently osteopathy has gained many
votaries. Old members of many a state legislature who have been
accustomed to ride for so long that exercise is almost an unknown
quantity in their lives, are treated by the osteopath and lose so many
vague pains and aches and discomforts of various kinds that it has not
been difficult to persuade them that it is a great new discovery in
medicine, and so in many of the states the osteopaths have secured
legal recognition.


Summary.--Exercise, as exercise, often does harm rather than good.
Thin people seldom need exercise, stout people seldom take enough of
it. No one should be encouraged to exercise merely that he may be able
to use up material that he has eaten, when it is evident that he is
eating more than is required for his ordinary occupation. The question
can never be settled without taking into consideration all these
individual peculiarities of each case. Properly used, exercise is one
of the most important therapeutic aids. But it is liable to as many
abuses as are drugs, and the patient's attitude of mind toward any
particular exercise is always an extremely important factor. If the
exercise produces fatigue and disgust, then it will do no good, in
spite of all that is hoped from it. If it creates true diversion of
mind, it will surely be precious, even though it may, for other
reasons, seem unsuitable.





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