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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