facts, i. e., the manner in which they have been affected by their running; second as to their opinions, i. e., 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 training 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 running 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 affections, irregularity, palpitation, etc. 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 "athlete'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 cardiac 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 vigorous 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, a 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 "athlete's heart." This was so in most of the cases mentioned above, nevertheless, all but three of the men have since been cured. "Athlete'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
