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°, 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 [{203}] 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 [{204}] 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.